Ascitic Fluid Analysis

Question 1

Appearance

Answer 1

Straw- serous effusion (clear- transudative, cloudy- exudative)

Bloody- trauma, malignancy, haemorrhagic pancreatitis, perforated peptic ulcer

Turbid- spontaneous bacterial peritonitis, perforated viscous

Chylous- malignancy, lymphoma, TB, parasitic

Question 2

High SAAG

Answer 2

Portal hypertension

Pre hepatic- portal vein thrombosis

Hepatic- cirrhosis, chronic hepatitis

Post hepatic- right heart failure, constrictive pericarditis, Budd chiari syndrome

Question 3

Low SAAG

Answer 3

Peritoneal disease- peritoneal dialysis, intra abdominal malignancy

Hypoalbuminaemia- nephrotic syndrome, malnutrition

Other- pancreatitis, myxoedema

Question 4

Neutrophils in ascetic fluid

Answer 4

More than 0.25x10 9 / L- SPB

Question 5

Other tests for ascitic fluid

Answer 5

Cytology- malignancy
Neutrophils- SBP, Lymphoyctes- inflammation, TB, malignancy
MC&S- identify infective cause
Glucose- decreased in TB and malignancy
Amylase- increased in pancreatitis, pancreatic trauma