Indian Journal of Pathology and Oncology 2020;7(1):137–142 Content available at: iponlinejournal.com Indian Journal of Pathology and Oncology Journal homepage: www.innovativepublication.com Original Research Article Analysis of ascitic fluid in differentiating transudate versus exudate - in a tertiary care centre Karthik Selvaraju 1 , M Sridevi 2, * 1 Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India 2 Dept. of Pathology, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India ARTICLE INFO Article history: Received 31-08-2019 Accepted 22-10-2019 Available online 22-02-2020 Keywords: Ascitic fluid total protein (AFTP) Serum Albumin Ascitic Gradient (SAAG) Paracentesis Cirrhosis ABSTRACT Introduction: Ascites is the accumulation of fluid within the peritoneal cavity. Normally, 5-20ml of peritoneal fluid is found between the layers of peritoneum, acting as a lubricant and reducing the friction of organ movement during digestion and bodily movements. The use of serum ascites albumin gradient has out dated the total protein measurement in differentiating transudate from exudate fluid. Analysis is done in two broad spectrums: (1) Biochemical analysis (2) Clinical pathology and Cytological analysis Aim & Objectives: This study was done with the objective to evaluate the ascitic fluid analysis for differentiating transudate versus exudate and also the characteristics of the peritoneal fluid in various causes of ascites. Materials and Methods: In this study, 100 patients of ascites were evaluated for ascitic fluid total protein (AFTP) and Serum Albumin Ascitic Gradient (SAAG) along with ultrasound and other required investigations. Ascitic fluid was obtained by Paracentesis, an invasive sampling procedure to remove fluid or air from the peritoneal cavity for diagnostic or therapeutic purposes. The fluid obtained is sent for analysis. Ascitic fluid analysis is a group of tests used to diagnose the etiology of fluid accumulation. Result: Study shows that ascites due to various aetiology is common among 31-50 years of age group with a slight male predominance. The present study suggests that transudative ascites are more common than exudative ascites with a percentage of 52%. Conclusion: Serum Albumin Ascitic Gradient (SAAG) is much more superior to ascitic fluid total protein (AFTP) in the differential diagnosis of Ascites. Ascitic fluid analysis helps in diagnosing the aetiology of ascites based on the cytological and biochemical parameters. The common aetiology for ascites reported in India is liver cirrhosis. The development of ascites in cirrhotic patients is associated with a mortality of 15% and 44% at one-year and five-year follow-up periods, respectively. © 2020 Published by Innovative Publication. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by/4.0/) 1. Introduction Ascites is the excessive accumulation of fluid in the peritoneal cavity. The normal peritoneal cavity contains a small amount of fluid (< 50mL) with high protein content. Accumulation of fluid in the peritoneal cavity resulting in ascites has many different mechanisms. 1,2 The most frequent cause of ascites is cirrhosis-related portal hypertension in 85% of cases; 15% of cases are * Corresponding author. E-mail address: dr.sridevi81@gmail.com (M. Sridevi). due to intraabdominal noncirrhotic conditions, including malignancies, infections, and cardiac and renal failure. 3 Under normal circumstances, the amount of peritoneal fluid depends on a balance between plasma flowing into and out of the blood and lymphatic vessels. It is only when this balance has been disrupted or in cases of inflammation or injury, ascites develops. The imbalance in the level of plasma may be due to increased capillary permeability, increased venous pressure, decreased protein (oncotic pressure), or increased lymphatic obstruction. https://doi.org/10.18231/j.ijpo.2020.026 2394-6784/© 2020 Innovative Publication, All rights reserved. 137