Role of ultrasonography in the diagnosis of the causes of resistant Ascites in liver cirrhosis

This study was performed on 75 patients with liver cirrhosis and ascites classified into two groups: Group I [50 patients with resistant ascites] and group II [25 patients with responding ascites]. The liver was significantly smaller in group I. Creatinine clearance and serum sodium were significantly lower in group I. Serum alkaline phosphatase and alpha fetoprotein were significantly higher in group I. Portal vein thrombosis was diagnosed in four patients of group I compared with one patient of group II. HCC was detected in six patients of group I and in none of group II. Ascitic fluid was positive for acid fast bacilli in one patient of group I. Culture was positive in four patients of group I compared with none of group II

Sonographic findings that could explain resistant ascites in patients with liver cirrhosis

75 patients with liver cirrhosis and ascites classified into 2 groups. Group I included 50 patients with resistant ascites and group II included 25 patients with responding acsites were the subject of this work. The liver was significantly smaller in group I. Creatinine clearance and serum Na were significantly lower in group I. Serum alkaline phosphatase and alpha fetoprotein were significantly higher in group I. Portal vein thrombosis was diagnosed in 4 patients of group I [8%] compared with one patient of group II [4%]. HCC was detected in 6 patients of group I [12%] and in none of group II patients. Ascitic fluid was positive for acid fast bacilli in one patient of group I. Culture was positive in 4 patients of group I, E. coli in 3 and Staph. aureus in one, compared with none of group II. The study stressed the importance of ultrasonography in detection of the cause of resistance of ascites and in the evaluation and regular follow-up of patients with liver cirrhosis