Ascitic Fluid Flashcards
What does SAAG stand for in the context of ascites?
Serum albumin - Ascites albumin
SAAG is used to determine the cause of ascites based on the serum albumin levels.
What is the significance of SAAG > 1.1 mg/dl?
Indicates cirrhosis, alcoholic hepatitis, cardiac ascites, mixed ascites, massive liver metastasis, fulminant hepatic failure, Budd-Chiari syndrome, portal vein thrombosis, veno-occlusive disease, myxedema, fatty liver of pregnancy
Conditions associated with portal hypertension.
What conditions are associated with SAAG < 1.1 mg/dl?
Peritoneal carcinomatosis, tuberculous peritonitis, pancreatic ascites, bowel obstruction, biliary ascites, nephrotic syndrome, postoperative lymphatic leak, serositis in connective tissue disease
These conditions are usually not associated with portal hypertension.
What does a red cell count of >100/microlitre in ascitic fluid indicate?
Malignancy, tuberculosis, intra-abdominal trauma (DPL)
Elevated red cell counts may suggest bleeding or malignancy.
What is the interpretation of a white cell count of >300/microlitre in ascitic fluid?
Abnormal, indicates SBP (90%), cirrhosis (50%)
A high white cell count can be indicative of infection or inflammation.
What does a white cell count of ‹300/microlitre signify?
Normal
This level is generally considered non-inflammatory.
What white cell differential indicates primary peritonitis?
> 25% neutrophils
Neutrophils are indicative of potential infection in the peritoneal cavity.
What condition is indicated by a white cell count with >25% lymphocytes?
Tuberculosis or chylous ascites
Lymphocytic predominance suggests specific infections.
Which condition is associated with mesothelial cells in ascitic fluid?
Peritoneal mesothelioma including ovarian Ca
What is the implication of finding gram-negative bacteria in ascitic fluid?
Possible infection
Gram-negative organisms are often associated with more severe infections.
What is the interpretation of a normal red cell count in ascitic fluid?
A normal count suggests no bleeding or malignancy.
In the context of ascites, what does the term ‘mixed ascites’ refer to?
A combination of different causes, potentially involving both portal hypertension and other factors
Mixed ascites can complicate diagnosis and management.
