Analysis of ascitic fluid in differentiating transudate versus exudate - in a tertiary care centre

Original Article

Author Details : Karthik Selvaraju, M Sridevi*

Volume : 7, Issue : 1, Year : 2020

Article Page : 137-142

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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.

Keywords: Ascitic fluid total protein (AFTP), Serum Albumin Ascitic Gradient, (SAAG), Paracentesis, Cirrhosis.

How to cite : Selvaraju K, Sridevi M, Analysis of ascitic fluid in differentiating transudate versus exudate - in a tertiary care centre. Indian J Pathol Oncol 2020;7(1):137-142

Copyright © 2020 by author(s) and Indian J Pathol Oncol. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (

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