Differential diagnosis of ascites: etiologies, ascitic fluid analysis, diagnostic algorithm

Abstract: Ascites is the pathological accumulation of fluid within the peritoneal cavity. It often occurs as results of liver cirrhosis, malignant neoplasia, tuberculous infection, cardiac insufficiency, renal diseases, etc. Determining the etiology is an essential step in the management of patients with new-onset ascites. Abdominal paracentesis with appropriate ascitic fluid analysis is probably the most cost-effective method of determining the cause of ascites. We performed a literature search of PubMed and identified articles published in the field of ascites, to evaluate diagnostic values of various parameters in defining the etiologies of ascites and then provides diagnostic algorithm for patients with new-onset ascites. In patients with ascites, the constituent ratio of underlying etiology varies between developed and developing countries. It is a challenge to define the etiologies of ascites in developing countries. Routine ascitic fluid analysis should include the serum ascites albumin gradient (SAAG), total protein concentration, cell count and differential. Optional ascitic fluid analysis includes cholesterol, fluid culture, cytology, tumor markers, lactate dehydrogenase, adenosine deaminase (ADA), triglyceride, amylase, glucose, brain natriuretic peptide (BNP), etc. Our review evaluated diagnostic values of the above parameters in defining the etiologies of ascites. Diagnostic algorithm established in this review would provide a practical and convenient diagnostic strategy for clinicians in diagnosing patients with new-onset ascites.

Location
Deutsche Nationalbibliothek Frankfurt am Main
Extent
Online-Ressource
Language
Englisch

Bibliographic citation
Differential diagnosis of ascites: etiologies, ascitic fluid analysis, diagnostic algorithm ; volume:62 ; number:7 ; year:2024 ; pages:1266-1276 ; extent:11
Clinical chemistry and laboratory medicine ; 62, Heft 7 (2024), 1266-1276 (gesamt 11)

Creator
Du, Li
Wei, Ning
Maiwall, Rakhi
Song, Yuhu

DOI
10.1515/cclm-2023-1112
URN
urn:nbn:de:101:1-2405301541486.703751794037
Rights
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Last update
14.08.2025, 10:45 AM CEST

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Associated

  • Du, Li
  • Wei, Ning
  • Maiwall, Rakhi
  • Song, Yuhu

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