Etiologic and Laboratory Analyses of Ascites in Patients who Underwent Diagnostic Paracentesis / 대한간학회지
The Korean Journal of Hepatology
;
: 185-195, 2007.
Article
in Korean
| WPRIM
| ID: wpr-34946
ABSTRACT
BACKGROUND/AIMS:
Liver cirrhosis and malignant tumors are two major causes of ascites according to the reports from Western countries, 80% and 10% respectively. Assuming that there might be regional differences in etiologies and changes in their frequency over time, we investigated causes of ascites and the diagnostic usefulness of various laboratory tests.METHODS:
Medical records of 366 patients, who underwent diagnostic paracentesis in the mid-1990s (1996 and 1997) and early 2000s (2001 and 2002), were retrospectively reviewed. The etiology was confirmed by histology, imaging studies, and ascites analyses.RESULTS:
The frequency of cirrhotic ascites was 59.6%, cancer-related 25.7%, tuberculous peritonitis 6.6%, and others 8.1%. Among cirrhotics, the frequency of cases related to hepatitis B decreased significantly from 72% to 55% over time, and alcoholic cirrhosis increased from 18% to 34%. Among cancer-related ascites, peritoneal carcinomatosis type was 75.5% (primary sites stomach 24.5%, pancreas 15.9%, colon 15.9%, lung 7.4%, etc), metastatic liver cancers 8.5%, hepatocellular carcinoma without cirrhosis 6.4%, etc. The sensitivity of serum-ascites albumin gradient for the diagnosis of cirrhotic ascites was 91.4%, and total protein in ascites also revealed a comparable diagnostic sensitivity, 90%. The diagnostic sensitivity of adenosine deaminase for tuberculous peritonitis was 94.2%, and its positive predictive value was 75%.CONCLUSIONS:
Liver cirrhosis is the leading cause of ascites, especially alcoholic cirrhosis has significantly increased. The next common etiology is cancer-related, and its frequency in Korea is higher than in western countries. Tuberculous peritonitis is still prevalent, and adenosine deaminase could precisely differentiate it from other causes.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Peritonitis, Tuberculous
/
Ascitic Fluid
/
Adenosine Deaminase
/
Prevalence
/
Predictive Value of Tests
/
Retrospective Studies
/
Paracentesis
/
Liver Cirrhosis
/
Liver Cirrhosis, Alcoholic
/
Neoplasms
Type of study:
Diagnostic study
/
Etiology study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
Korean
Journal:
The Korean Journal of Hepatology
Year:
2007
Type:
Article
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