Smear of duodenal fluid aspirate

Alternative names
Duodenal aspirated fluid smear

Definition
Smear of duodenal fluid aspirate is an examination of fluid from the duodenum for a possible infection. Usually the health care practitioner is looking for either giardia or strongyloides.

How the test is performed
The specimen is obtained by EGD (esophagogastroduodenoscopy), a flexible scope that is passed through the digestive tract to the duodenum for the purpose of viewing the organs and obtaining specimens.

The test may also be performed by passing a thin flexible tube into the small intestine. The position of the tube can be confirmed by the pH (acid-base balance) of the fluid or by an x-ray.

Fluid is aspirated from the duodenum when the tube or the scope is in proper position. The fluid is placed on a microscope slide and stained for examination.

How to prepare for the test
Withhold food and fluid for 12 hours before the test.

Infants and children:
The preparation you can provide for this test depends on your child’s age, previous experiences, and level of trust. For general information regarding how you can prepare your child, see the following topics:

     
  • Infant test or procedure preparation (birth to 1 year)  
  • Toddler test or procedure preparation (1 to 3 years)  
  • Preschooler test or procedure preparation (3 to 6 years)  
  • Schoolage test or procedure preparation (6 to 12 years)  
  • Adolescent test or procedure preparation (12 to 18 years)

How the test will feel
You may have a gagging sensation as the tube is passed, but it is usually not painful.

Why the test is performed
The test is performed to diagnose infection of the small bowel. In most cases, this test is only done when stool examinations and a duodenal string test have been unable to confirm the diagnosis.

Normal Values
Normally, the contents of the duodenum are sterile (no organisms are seen).

What abnormal results mean
The results may show the presence of giardia protozoa and large white blood cells (called macrophages), or the intestinal parasite strongyloides, or another infectious organism.

What the risks are
The risks may include bleeding, perforation (hole), and infection. Certain pre-existing conditions may prohibit use of this test.

Special considerations
Other, less invasive, tests can often be performed to detect the presence of giardia and other infections.

Johns Hopkins patient information

Last revised: December 3, 2012
by Gevorg A. Poghosian, Ph.D.

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