Abstract

Ascites is a manifestation of various number of diseases and the aetiopathogenesis of ascites is varied. The differential diagnosis of ascites remains a clinical problem. Although cirrhosis is the cause of ascites in most patients (80%), approximately 20% have a cause other than liver disease. Approximately 5% of patient with ascites have more than one cause (i.e. ‘mixed’ ascites). The present study was conducted on 75 consecutive patients admitted to indoor wards, Department of Medicine, Mayo Institute of Medical Science, Barabanki (UP), between June 2015 to May 2016 of age group 18–70 years having clinical symptoms and signs of ascites. Samples of blood and ascitic fluid were obtained simultaneously. The aim of present study was to evaluate various parameters especially serum ascitic fluid albumin gradient in case of ascites in an Indian setting and to compare the SAAG with the AFTP levels in terms of usefulness in establishing a cause of ascites. In the present study value of SAAG was 1.56 ± 0.37 gm/dl (mean ± standard deviation) for patients with portal hypertension related ascites whereas for non – portal hypertension related ascites excluding cardiac ascites SAAG was 0.95 ± 0.14 gm%. Corresponding values for cirrhosis and cardiac ascites were 1.6 ± 0.39 gm/dl and 1.44 ± 0.21 gm/dl respectively. It was observed that SAAG in cardiac ascites group (even though placed in non portal hypertension related ascites group based on absence of portal hypertension) resembled the SAAG of portal hypertension related ascites group. It was concluded from our present study that serum ascitic fluid albumin gradient(SAAG) is a better diagnostic parameter than ascitic fluid total protein (AFTP) in the patients having ascites. During the study we observed that SAAG has greater sensitivity and specificity values in comparision to AFTP for detection of portal hypertension related ascites.

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