diagnostic approach to ascites: a prospective study of 100 patients

ABSTRACT

In a prospective study of 100 patients with ascites the major causes were cirrhosis in 53%, intraabdominal tumors in 17%, TB peritonitis in 15% and heart disease in 10% of patients. Helpful clinical observations included, lone ascites suggesting TB peritonitis, splenomegaly pointing to cirrhosis and abdominal masses suggesting malignancy. Helpful biochemical data in cirrhosis were urinary urobilinogen, low serum albumen and high Y globulin. High ascites protein and cell count point to TB or malignancy, whereas haemorrhagic fluid is strongly suspicious of malignancy. Peritoneoscopy and biposy are diagnostic, particularly in TB and malignancy. However, a thorough clinical assessment is still the best method of diagnosis since it ellucidated the aetiology in 94% of cases