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Ascites is detected with physical examination of the abdomen by visible bulging of the flanks in the reclining person ("flank bulging"), "shifting dullness" (difference in percussion note in the flanks that shifts when the person is turned on the side), or in massive ascites, with a "fluid thrill" or "fluid wave" (tapping or pushing on one side ...
The serum-ascites albumin gradient (SAAG) is the most useful index for evaluating peritoneal fluid and can help distinguish ascites caused by portal hypertension (cirrhosis, portal vein thrombosis, Budd-Chiari syndrome, etc.) from other causes of ascites. SAAG is calculated by subtracting the albumin measure of ascitic fluid from the serum value.
Ascites is most commonly a complication of cirrhosis of the liver. [1] It can also occur in patients with nephrotic syndrome. [3] [4] SBP has a high mortality rate. [5] The diagnosis of SBP requires paracentesis, a sampling of the peritoneal fluid taken from the peritoneal cavity. [6]
In people with ascites, a diagnosis of peritonitis is made via paracentesis (abdominal tap): More than 250 polymorphonuclear cells per μL is considered diagnostic. In addition, Gram stain is almost always negative, whereas culture of the peritoneal fluid can determine the microorganism responsible and determine their sensitivity to ...
The serum-ascites albumin gradient can help determine the cause of the ascites. [7] The color of the ascitic fluid can also be useful in analysis. Blood fluid can indicate trauma or malignancy. A milky appearance of the fluid can indicate lymphoma or malignant peritoneal ascites. Cloudy or turbid fluid can indicate possible infection or ...
Abdominal distension can also be a symptom of ovarian cancer. Women are more prone to bloating and often identify these symptoms during menstruation . [ 6 ] Some individuals who develop distension may have either poor motility of their intestines or may be hypersensitive to gut sensations. [ 7 ]
Alcoholic hepatitis is distinct from cirrhosis caused by long-term alcohol consumption. Alcoholic hepatitis can occur in patients with chronic alcoholic liver disease and alcoholic cirrhosis. Alcoholic hepatitis by itself does not lead to cirrhosis, but cirrhosis is more common in patients with long term alcohol consumption. [6]
In gastroenterology, the puddle sign is a physical examination maneuver that can be used to detect the presence of ascites. It is useful for detecting small amounts of ascites—as small as 120 mL; shifting dullness and bulging flanks typically require 500 mL. [1] The steps are outlined as follows: [2] Patient lies prone for 5 minutes