Abstract
Background: Ascitic fluid usually forms slowly as a result of obstruction of proximal vascular systems (Venous, lymphatic). It may also form directly in response to disease involving the peritoneum. Differentiation between malignancy related and non-malignantascites is a challenge that is not always met satisfactorily. Both malignant and tuberculous ascites are exudative in nature with lymphocytic predominance and low Serum Ascitic Fluid Albumin Gradient values can not be differentiated easily form each other. Studies have shown that parameters like ascitic fluid cholesterol have been superior to the conventional method of ascitic fluid analysis in discriminating ascites caused by malignancy from others. Method: This study was conducted in the Department of Pathology, Shyam Shah Medical College, Rewa during the period from May 2009 to October 2011. The study comprised of 100 patients with different causes of ascites admitted to wards of S.G.M.H. Rewa. Result: Cases were divided in to 3 groups. Groups I consists of patents(39 male and 31 female) with ascites due to chronic liver disease and other non tubercular and non neoplastic diseases, Group II consists of 20 patients (4 male and 16 female) with ascites due to tuberculosis, Group III consists of 10 patients (4 male and 6 female) with ascites due to malignant diseases. Ascitic fluid cholesterol level was found to be 32.9571±7.1183mg%,0.05±9.047gm%, 74.1±16.1707mg% in Group I, Group II and Group III respectively. On comparing Group III with I and II values were found to be highly significant (p 0.05). The value of ascitic fluid cholesterol level found in Group III was comparatively higher (>54.5mg%) than Group I and Group II with an exception in one case, where we found a higher level of cholesterol. Conclusion: In our study we found a significant raised cholesterol level (74.1 ±16.1707mg%) well above the cut off value (54.5mg%) and it has got a good differentiating potential for determining malignant ascites from non-malignant ascites. DOI: 10.21276/APALM.1371
Highlights
Ascitis defined as accumulation of free fluid in the peritoneal cavity
The value of ascitic fluid cholesterol level found in Group III was comparatively higher (>54.5mg%) than Group I and Group II with an exception in one case, where we found a higher level of cholesterol
Albumin gradient does not explain the etiology of ascites, if Serum Ascites Albumin Gradient (SAAG) is more>1.1, the patient is diagnosed to be having portal hypertension
Summary
Ascitis defined as accumulation of free fluid in the peritoneal cavity. Ascitic fluid usually forms slowly as a result of obstruction of proximal vascular systems (Venous, lymphatic). A low gradient (
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