Body Fluid Analysis -Ascitic Fluid
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🧪 Body Fluid Analysis – Ascitic Fluid
Parameter | Details |
|---|---|
Test Name | Ascitic Fluid Analysis (Peritoneal Fluid Analysis) |
Sample Type | Ascitic fluid (via paracentesis from peritoneal cavity) |
Fasting Required | ❌ Not required |
Organ System | Peritoneum (Abdominal cavity) |
Common Conditions | Liver cirrhosis, tuberculosis, cancer, nephrotic syndrome, pancreatitis |
🧬 What Is Ascitic Fluid?
Ascitic fluid is the abnormal accumulation of fluid in the peritoneal cavity — the space within the abdomen that houses the liver, intestines, and other organs. Its presence is known as ascites.
🎯 Purpose of the Test
Ascitic fluid analysis is used to:
- Diagnose the cause of ascites
- Differentiate transudate vs. exudate
- Identify infections (spontaneous bacterial peritonitis, TB)
- Detect malignancy (e.g., peritoneal carcinomatosis)
- Assess complications in liver disease
📊 Key Parameters Measured in Ascitic Fluid
Test | Interpretation / Use |
|---|---|
Appearance | Clear = normal/transudate; Cloudy = infection; Bloody = malignancy/trauma |
Cell Count | ↑ WBC = infection or malignancy; Neutrophils >250 cells/mm³ → possible SBP |
Protein | <2.5 g/dL = transudate (e.g., cirrhosis); >2.5 = exudate (e.g., TB, cancer) |
Serum-Ascites Albumin Gradient (SAAG) | >1.1 g/dL = portal hypertension; <1.1 = exudative ascites |
Glucose | ↓ in infection, malignancy, or TB |
LDH | ↑ in infection, cancer |
Amylase | ↑ in pancreatic ascites or GI perforation |
Adenosine Deaminase (ADA) | ↑ (>30–40 U/L) → suggests tuberculous peritonitis |
Culture & Gram Stain | Identifies bacteria in spontaneous or secondary bacterial peritonitis |
AFB Stain / TB PCR (CBNAAT) | Detects Mycobacterium tuberculosis in suspected TB peritonitis |
Cytology | Detects malignant cells in cancer-related ascites |
🧪 Key Classification: SAAG
SAAG (Serum-Ascites Albumin Gradient) | Likely Cause |
|---|---|
≥1.1 g/dL | Transudate – Cirrhosis, heart failure |
<1.1 g/dL | Exudate – TB, cancer, pancreatitis, infection |
SAAG = Serum albumin – Ascitic fluid albumin
⚠️ Common Conditions Diagnosed
Disease | Typical Features in Fluid |
|---|---|
Cirrhosis (most common cause) | High SAAG, low protein, clear appearance |
Spontaneous Bacterial Peritonitis (SBP) | High neutrophils (>250/mm³), positive culture |
Tuberculous Peritonitis | High protein, high ADA, lymphocyte predominant, low SAAG |
Malignancy | Bloody/turbid fluid, abnormal cytology, high protein, low SAAG |
Pancreatic Ascites | High amylase, low SAAG |
🧬 Recommended Further Tests
Additional Test | Purpose |
|---|---|
CBC, ESR, CRP | Detect systemic inflammation/infection |
Liver Function Tests (LFT) | Assess liver damage or cirrhosis |
Ultrasound Abdomen | Visualize fluid pockets and organ changes |
AFB smear, TB PCR (GeneXpert) | Confirm TB etiology |
CT Abdomen | Detect tumors, peritoneal thickening |
Cytology | Malignant cell detection |
📌 Summary Table
Parameter | Ascitic Fluid Analysis |
|---|---|
Sample Required | Peritoneal fluid from paracentesis |
Main Uses | Diagnose ascites cause, infection, TB, cancer, cirrhosis |
Key Differentiator | SAAG (Serum-Ascites Albumin Gradient) |
Important Markers | Protein, ADA, Cell count, Culture, Cytology |
Recommended With | LFT, TB PCR, Ultrasound, CBC, ADA, AFB stain |
How our test process works!
