CYTOLOGIC DIAGNOSIS OF BILE PERITONITIS

Bile perironitis (BP) is a rare but acute and serious condition that m ay be associated with high mortality. BP results from generalized or l ocalized leakage of bile into the peritoneal cavity. Ar best, radiolog ic studies may be suggestive of BP. We observed a spectrum of cytologi c findings in aspirated peritoneal fluids (PF) from 3 patients with BP . Occasional bile pigment-laden macrophages, extracellular lakes of gr een stringy material admired with variable numbers of histiocytes, mes othelial cells, and acute and chronic inflammatory cells, were seen. N umerous candida were present in one case. To the best of our knowledge , this is the first report describing the cytologic features of BP. Cy tology is a simple, rapid, and cost-effective means of examining PF, a nd can therefore play a significant role in establishing the diagnosis of BP. Early recognition of BP can result in rapid, therapeutic inter vention that may prevent significant morbidity and mortality. (C) 1996 Wiley-Liss, Inc.