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Several review articles mention the use of these but the original literature, in my opinion, is not very convincing: Amylase levels in ascitic fluid by Runyon BA, J Clin Gastoenterol 1987; 9: 172-4. is quoted but does not mention intestinal perforation although establishes that in non-pancreatic ascites the RR for for ascitic amylase is very similar to serum RR. Could try Alonyo D and PerryJF Jr J Trauma 1981; 21: 345-348 Value of quantitative cell count and amylase activity of peritoneal lavage fluid or Amerson JR, Howard JM, Vowles KDJ. Ann Surgery 1958; 147: 245-250 - The amylase concentration in serum and peritoneal fluid following perforation of gastroduodenal ulcers. Bilirubin may be useful where biliary perforation is a possibility - the ref states ascitic bilirubin >6mg/dl (sorry about the units) and > serum level suggests bowel or biliary perforation - also remarks that fluid brown in colour. Runyon BA, Ascitic fluid bilirubin concentration as a key to the diagnosis of choleperitoneum J Clin Gastoenterol 1987; 9: 543-5. Presumably if a perforation is suspected there isn't a great deal of time to wonder about the niceties of ascitic fluid measurement, all of which must include the caveats of using assay in samples for which they are not validated. Anne Tarn ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/