TY  - CHAP
M1  - Book, Section
TI  - Paracentesis (Abdominal)
A1  - Gomella, Tricia Lacy
A1  - Eyal, Fabien G.
A1  - Bany-Mohammed, Fayez
Y1  - 2020
N1  - 
T2  - Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e
AB  - To  obtain  peritoneal  fluid  for  diagnostic  tests  to  determine  the  cause  of  ascites.  Ascites  is  an  excessive  amount  of  fluid  in  the  peritoneal  cavity,  and  in  the  neonate,  it  is  usually  urinary,  biliary,  or  chylous.  Other  causes  can  occur  but  are  less  common.Urinary  ascites.  Due  to  perforation  of  the  ureter,  renal  pelvis,  or  bladder  (often  caused  by  a  distal  urinary  tract  obstruction  and  proximal  buildup  of  pressure).  The  most  common  neonatal  cause  is  posterior  urethral  valves.  Rare  causes:  ureterocele,  ureteral  or  urethral  stenosis,  persistent  cloaca,  neurogenic  bladder,  urogenital  sinus,  congenital  nephrotic  syndrome,  bladder  neck  obstruction,  and  renal  vein  thrombosis.Biliary  ascites.  Due  to  perforation  in  the  extrahepatic  biliary  tree  (most  common  site  is  junction  of  common  bile  duct  with  cystic  duct),  injury  to  the  bile  ducts,  or  a  choledochal  cyst.Chylous  ascites.  Usually  idiopathic.  Causes  include:  congenital  chylous  ascites  (most  commonly  caused  by  a  malformation  of  the  lymphatic  duct  causing  an  obstruction  or  inadequate  drainage  of  the  intraabdominal  lymphatic  system),  “leaky  lymphatics,”  lymphangiectasia,  external  compression  (malrotation,  intussusception,  mesenteric  cyst,  incarcerated  hernia),  complication  following  neonatal  surgery  and  others.Hepatocellular  ascites.  Can  be  caused  by  neonatal  hepatitis,  viral  hepatitis,  α1-antitrypsin  deficiency,  congenital  hepatic  fibrosis,  storage  disorders,  Budd-Chiari  syndrome,  or  hepatic/portal  vein  thrombosis.Pancreatic  ascites.  Usually  caused  by  trauma,  infection,  anatomical  lesions,  congenital  pancreatic  pseudocyst.Gastrointestinal  tract  causes  of  ascites.  Any  perforation  of  the  gastrointestinal  tract:  necrotizing  enterocolitis  (NEC)  with  perforation/peritonitis,  meconium  peritonitis,  perforation  of  the  Meckel  diverticulum,  atresia,  malrotation,  volvulus,  gastroschisis,  omphalocele,  post  abdominal  surgery,  or  intussusception.  Peritonitis  in  neonates  is  most  commonly  associated  with  gastrointestinal  perforations.Infections.  Most  commonly  congenital  (cytomegalovirus  [CMV],  toxoplasmosis,  syphilis,  and  others)  but  can  also  be  from  fungal  (most  common  Candida  albicans),  viral  (parvovirus,  enterovirus),  or  bacterial  infections  (tuberculosis,  salmonella).Inborn  errors  of  metabolism.  Glycogen  storage  disorders,  lysosomal  storage  disorders,  and  galactosemia  can  all  cause  ascites.  Examples  include  infantile  free  sialic  acid  storage  disorder  (ISSD),  Salla  disease,  GM1  gangliosidosis,  Gaucher  disease,  and  α1-antitrypsin  deficiency.Cardiac  abnormalities.  Congestive  heart  failure,  arrhythmias,  and  right-sided  heart  obstruction.Chromosomal  causes.  Turner  syndrome  and  trisomy  21.Iatrogenic.  Can  occur  from  fluid  from  central  venous  catheters  or  intraperitoneal  extravasation  of  fluids  from  an  umbilical  vein  catheterization–related  perforation,  gastric  perforation  from  gastric  tubes.Hemoperitoneum  (bloody  ascites).  Uncommon  but  can  be  nontraumatic  (hepatoblastoma),  secondary  to  birth  trauma  (hepatic,  splenic,  or  adrenal),  or  secondary  to  a  ruptured  internal  organ.  Splenic  trauma  can  be  associated  with  consumptive  coagulopathy.As  a  therapeutic  procedure  to  relieve  pressure  and  aid  in  ventilation  in  a  patient  with  cardiorespiratory  compromise.  Examples  include  removal  of  peritoneal  fluid  from  massive  ascites  or  air  from  a  pneumoperitoneum.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/16
UR  - accesspediatrics.mhmedical.com/content.aspx?aid=1168356467
ER  -