To the Editor:—
The value of using abdominal paracentesis and peritoneal lavage to detect acute intraabdominal pathologic conditions is well reported in the literature. The appearance, color, odor, pH, amylase levels, cell counts, and bacteriological examinations of the fluid can be used to detect bleeding, evidence of perforated viscus, pancreatitis, peritonitis, strangulated bowel, etc.Root et al1 showed that an elevated white blood cell count (more than 2,000/cu mm) in the peritoneal fluid is significant for the diagnosis of ruptured viscera. The interval from time of peritoneal injury to initial appearance of leukocytes in the aspirated fluid is about two hours. Mansberger2 reported that elevated ammonia levels above 3.0 μg/cc in peritoneal fluid could rule out pancreatitis and suggested the presence of strangulated, perforated ulcers, lacerated intestine, or urinary extravasation. Another possible test of the peritoneal fluid for evidence of intestinal perforation is suggested here.During the course