Correlation Seminar

Topic :Ascites

Sandeep Neupane
1654
MBBS 2nd year
Objective:

To describe the difference in the ascitic fluid caused by

alcoholic cirrhosis and that caused by abdominal
tuberculosis.
Ascites

Accumulation of excess fluid within the peritoneal cavity

is called ascites.
It usually becomes clinically detectable when at least 500
ml of fluid has been accumulated.
Usually exists in 3 grades:
1) Grade 1
2) Grade 2
3) Grade 3
 Forms of ascitic fluid:
Transudate:
Extravascular fluid with low protein content and low
specific gravity.

-High hydrostatic pressure -Low osmotic pressure

Portal HTN Hypoalbuminemia
Heart failure Nephrotic syndrome
Kwashiorkor Kwashiorkor
Budd-Chiari syndrome

Cirrhosis of liver leads to transudative ascitic fluid.

 Exudate
It is extravascular fluid with high protein content and
cellular debris. It is mainly due to increase in vascular
permeability due to inflammation.
Eg: Abdominal tuberculosis
Peritonitis
Pancreatitis
 Cirrhotic ascites Tuberculous ascites
(Transudate) (Exudate)

Main Causes hydrostatic pressure Inflammation

colloid osmotic pressure ed vascular permeability

Appearance Clear Cloudy

Specific gravity <1.012 >1.020

Protein content <2.5 g/dl >2.9 g/dl

SAAG >1.1 g/dl <1.1 g/dl

Lactate dehydrogenase(LDH) <200 U/l >200 U/l

Glucose content Similar to serum glucose Decreased

Cells <250/cu.mm(low) Endothelial cells >250/cu.mm(high)

,mesothelial cells and occasional Lymphocytes(70%) and Neutrophils,
lymphocytes Tubercle bacilli present
pH >7.3 <7.3
Bibliography:

Robbins and Cotran Pathologic Basis of disease,9th edition

Harrisons Principles of Internal Medicine,19th edition
Davidsons Principles and Practice of Medicine,23rd edition
Bedside Clinics in Medicine, Anup Kumar Kundu,7th edition
Textbook of Biochemistry for Medical Students, DM Vasudevan, Sreekumari S,
Kannan Vaidyanathan, 7th edition

Thank You!!!