CLINICOPATHOLOGICAL CORRELATION OF ASCITES WITH SPECIAL REFERENCE TO SERUM ASCITIC FLUID ALBUMIN CONCENTRATION GRADIENT (SAAG)- A STUDY IN A TERTIARY CARE CENTRE OF GAJRAULA, UTTAR PRADESH
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 18
Abstract
BACKGROUND Ascites is defined as collection of excessive fluid in peritoneal cavity. Normally there is little fluid between the visceral and parietal layers of peritoneum. A slight increase in normal volume of peritoneal fluid occurs in hepatic disease, cardiac disease and malignancies of pelvic and abdominal organs. The earlier approach in differential diagnosis constituted, separation of fluids on the basis of protein concentration in the ascitic fluid; defining transudate if protein levels are < 2.5 gm/dl and exudates if above that. Ascitic fluid protein estimation has long been used to divide ascitic fluid into exudates and transudate. Serum Ascitic Fluid Albumin Concentration Gradient (SAAG) has been reported to provide differentiation between portal hypertension related and non-related ascites. Therefore, the present study was undertaken to evaluate the role of serum-ascitic fluid-albumin-concentration gradient for the immediate etiologic diagnosis of ascites in order to simplify ascitic fluid analysis. METHODS This is a descriptive study. We studied 140 cases of ascites over a period of one year from Feb. 2018 to Feb. 2019. Samples for this study were collected from various outpatients and inpatients admitted in Medicine and Surgical Wards. RESULTS This study was conducted in the Department of Pathology, Venkateshwara Institute of Medical Sciences, Gajraula, Uttar Pradesh, India, taking into account 140 cases of ascites. Transudative ascites was found in 84.3% cases and the remaining 15.7% cases had exudative ascites. The commonest cause of transudative ascites was liver cirrhosis in 65% cases, followed by congestive cardiac failure in 8.6% cases, nephrotic syndrome in 6.4% cases and anaemia hypoproteinaemia in 4.3% cases. The cause of exudative ascites was tuberculosis in 10% cases and malignancy in 5.7% cases. Ascitic fluid total protein concentration was <3 gm/dl in all the cases of liver cirrhosis, congestive heart failure, nephrotic syndrome and anaemia-hypoproteinaemia; while in cases of tuberculous and malignant ascites it was >3 gm/dl. The highest protein concentration in ascites was 5.8 gm/dl found in a case of malignant ascites. CONCLUSIONS Serum Ascitic fluid albumin gradient is a better parameter for classification of cases of ascites than total protein concentration.
Authors and Affiliations
Vinay Sharma, Rachna Sharma, Sushil Sharma, Neetu Goyal
Keywords
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- EP ID EP617239
- DOI 10.14260/jemds/2019/329
- Views 81
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