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The serum-ascites albumin gradient or gap (SAAG) is a calculation used in medicine to help determine the cause of ascites. [1] The SAAG may be a better discriminant than the older method of classifying ascites fluid as a transudate versus exudate. [2] The formula is as follows: SAAG = (serum albumin) − (albumin level of ascitic fluid).
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 (/ ə ˈ s aɪ t i z /; [5] Greek: ἀσκός, romanized: askos, meaning "bag" or "sac" [6]) is the abnormal build-up of fluid in the abdomen. [1] Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. [4]
If the fluid causing the dullness was not free, then the air-fluid level would not move. Shifting dullness is usually present if the volume of ascitic fluid is up to 500 mL ml [ citation needed ] . If low volume ascites is suspected, then an attempt to elicit the puddle sign may be performed.
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
In medicine, the fluid wave test or fluid thrill test is a test for ascites (free fluid in the peritoneal cavity). It is performed by having the patient (or a colleague) push their hands down on the midline of the abdomen. The examiner then taps one flank, while feeling on the other flank for the tap.
Diagnosis is made by paracentesis (needle aspiration of the ascitic fluid); SBP is diagnosed if the fluid contains neutrophils at greater than 250 cells per mm 3 (equals a cell count of 250 x10 6 /L) fluid in the absence of another reason for this (such as inflammation of one of the internal organs or a perforation). [1] [10]
Overall direction of fluid flow in relation to equal bidirectional flow is shown by the orange and black lines, respectively. Oncotic pressure , or colloid osmotic-pressure , is a type of osmotic pressure induced by the plasma proteins , notably albumin , [ 1 ] in a blood vessel's plasma (or any other body fluid such as blood and lymph ) that ...