Ascites, Ascites Baby
100
Name three causes of ascites with a LOW SAAG gradient
Low SAAG (<1.1 g/dL) — No Portal Hypertension (high protein in fluid!)
Common causes include:
- Peritoneal carcinomatosis / malignancy
- Tuberculous peritonitis
- Pancreatic ascites
- Serositis (e.g., SLE)
- Bowel perforation / secondary peritonitis
- Nephrotic syndrome / severe hypoalbuminemia
200
This lab value can help distinguish between cardiogenic and cirrhotic causes of ascites.
What is Ascities total protein.
300
These three additional paracentesis studies should be checked when you are concerned about secondary peritonitis.
1.Total protein >1 g/dL
2. Glucose <50 mg/dL
3. LDH > the serum upper limit of normal
These are the three additional ascitic fluid studies used in Runyon’s criteria to help distinguish secondary bacterial peritonitis from spontaneous bacterial peritonitis (SBP).
The physiology is intuitive: higher protein reflects greater inflammatory/peritoneal injury and protein-rich exudate; low glucose reflects consumption by bacteria and inflammatory cells; and high LDH reflects tissue injury and intense inflammation.