Evaluation of transabdominal ultrasound as a tool for predicting the success of abdominocentesis in horses.
Authors: Beccati F, Nannarone S, Gialletti R, Lotto E, Cercone M, Dante S, Bazzica C, Pepe M
Journal: The Veterinary record
Summary
# Editorial Summary: Transabdominal Ultrasound for Predicting Abdominocentesis Success When evaluating horses with suspected peritoneal disease, practitioners often use transabdominal ultrasound to assess fluid accumulation before performing abdominocentesis, yet the predictive value of negative ultrasound findings remained unclear. Beccati and colleagues examined 109 horses undergoing both transabdominal ultrasonography (using a standardised 4-point grading system) and abdominocentesis, analysing the association between ultrasound detection of peritoneal fluid and successful sample retrieval. Ultrasound identified peritoneal fluid in 72% of horses, and diagnostic fluid was obtained from 93% of these cases; however, the critical finding was that even among the 28% where no fluid was detected ultrasonographically, 70% still yielded sufficient fluid for gross, clinicopathological and cytological assessment. Whilst a positive ultrasound examination significantly increases the likelihood of obtaining diagnostic peritoneal fluid, practitioners should not be discouraged from performing abdominocentesis based on negative or equivocal ultrasound findings, as clinically useful samples can frequently be retrieved regardless—making ultrasound a helpful but not definitive predictor of procedural success.
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Practical Takeaways
- •Ultrasound is a useful but imperfect predictor of abdominocentesis success—proceed with the procedure even if no free fluid is visible, as diagnostic samples can still be obtained 70% of the time
- •A negative ultrasound finding should not discourage clinicians from attempting abdominocentesis when clinical suspicion of abdominal disease warrants investigation
- •Use the 4-point grading system for peritoneal fluid assessment to standardize documentation and improve communication about peritoneal findings
Key Findings
- •Peritoneal fluid was ultrasonographically identified in 72% of horses, with fluid successfully collected from 93% of these cases
- •Even when no peritoneal fluid was detected on ultrasound (28% of cases), fluid was still collected in 70% of cases
- •Significant association exists between ultrasound detection of peritoneal fluid and likelihood of obtaining diagnostic fluid at abdominocentesis
- •Absence of fluid on ultrasound does not preclude successful fluid collection for cytological and clinicopathological evaluation