Which of the following statements concerning intraperitoneal fluid collections are correct?

A. Ascites occurs when either the peritoneal fluid secretion rate increases or the absorption rate decreases.

B. Accumulation of lymph within the peritoneal cavity usually results from trauma as tumor involving the intraabdominal lymphatic structures.

C. Choleperitoneum (intraperitoneal bile) generally occurs following biliary surgery, but spontaneous perforation of the bile duct has been reported.

D. The most common cause of hemoperitoneum is trauma to the liver or spleen.

DISCUSSION: Normally, there is a balance between fluid secretion and absorption in the peritoneal cavity. Ascites occurs when either the secretion rate increases or the absorption rate decreases disproportionately. Accumulation of lymph in the peritoneal cavity usually results from trauma or tumor involving lymphatic structures. Proposed treatment regimens range from salt restriction and diuretics to surgical ligation and peritoneovenous shunting. Uninfected bile is a mild irritant to the peritoneal cavity and causes increased production of peritoneal fluid, resulting in bile ascities or choleperitoneum. Most cases of choleperitoneum follow biliary tract surgery, but cases of spontaneous bile duct perforation have been reported in infants and some adults. The most common cause of hemoperitoneum is trauma to the liver or spleen. Less common causes include ruptured ectopic pregnancy, ruptured aortic aneurysms, and other intraabdominal injuries.