Ascites other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Paracentesis is sampling ascites fluid through abdominal wall with overall complication rate of not more than 1%. The sampled fluid will be surveyed upon total protein concentration, neutrophil count, and inoculation into blood culture bottles.

Other diagnostic studies

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Paracentesis

• Paracentesis is sampling ascites fluid through abdominal wall with overall complication rate of not more than 1%.
• The sampled fluid will be surveyed upon:
  • Total protein concentration
  • Neutrophil count
  • Inoculation into blood culture bottles
• Paracentesis findings include:
  • Protein concentration <1.5 g/dL is predictive of high risk for spontaneous bacterial peritonitis (SBP)
  • Neutrophil count of > 250 per mm³ is diagnostic of SBP
  • Positive culture of ascites fluid is diagnostic of SBP
  • Measuring serum-ascites albumin gradient (SAAG) is also helpful for diagnosing the underlying disease

Ascitic fluid measurements (American Association for the Study of Liver Diseases)

Routine Tests	Optional (infection suspicion)	Unusual	Unhelpful
Cell count and differential Albumin Total protein	Culture Glucose Lactate dehydrogenase Amylase Gram's stain	Acid fast bacterial stain and culture Cytology Triglyceride Bilirubin	pH Lactate Cholesterol Fibronectin Glycosaminoglycan