Template:Ascites Evaluation

Ascites Diagnosis

The differential diagnosis of ascites is often clarified by the calculation of the serum albumin to ascites gradient (SAAG)

SAAG = (serum albumin in g/dL) − (ascitic albumin in g/dL)

• High SAAG > 1.1 g/dL – Indicative of portal hypertension
  • Cirrhosis
  • Heart failure
    • Ascites total protein > 2.5 g/dL suggests cardiac ascites
  • Alcoholic hepatitis
  • Budd-Chiari syndrome
  • Portal vein thrombosis

• Low SAAG < 1.1 g/dL
  • Malignancy / peritoneal carcinomatosis
  • Nephrotic syndrome
  • Pancreatitis
  • Peritoneal tuberculosis
  • Serositis
  • Bowel infarction
  • Chylous