[Etiologic and laboratory analyses of ascites in patients who underwent diagnostic paracentesis].

Abstract

BACKGROUND/AIMS:

Liver cirrhosis and malignant tumors are two major causes of ascites according to the reports from Western countries, 80% and 10% respectively. Assuming that there might be regional differences in etiologies and changes in their frequency over time, we investigated causes of ascites and the diagnostic usefulness of various laboratory tests.

METHODS:

Medical records of 366 patients, who underwent diagnostic paracentesis in the mid-1990s (1996 and 1997) and early 2000s (2001 and 2002), were retrospectively reviewed. The etiology was confirmed by histology, imaging studies, and ascites analyses.

RESULTS:

The frequency of cirrhotic ascites was 59.6%, cancer-related 25.7%, tuberculous peritonitis 6.6%, and others 8.1%. Among cirrhotics, the frequency of cases related to hepatitis B decreased significantly from 72% to 55% over time, and alcoholic cirrhosis increased from 18% to 34%. Among cancer-related ascites, peritoneal carcinomatosis type was 75.5% (primary sites: stomach 24.5%, pancreas 15.9%, colon 15.9%, lung 7.4%, etc), metastatic liver cancers 8.5%, hepatocellular carcinoma without cirrhosis 6.4%, etc. The sensitivity of serum-ascites albumin gradient for the diagnosis of cirrhotic ascites was 91.4%, and total protein in ascites also revealed a comparable diagnostic sensitivity, 90%. The diagnostic sensitivity of adenosine deaminase for tuberculous peritonitis was 94.2%, and its positive predictive value was 75%.

CONCLUSIONS:

Liver cirrhosis is the leading cause of ascites, especially alcoholic cirrhosis has significantly increased. The next common etiology is cancer-related, and its frequency in Korea is higher than in western countries. Tuberculous peritonitis is still prevalent, and adenosine deaminase could precisely differentiate it from other causes.

• Authors: Young Hwangbo, Ji Heon Jung, Jaejoon Shim, Byung Ho Kim, Sung Hoon Jung, Chang Kyun Lee, Jae Young Jang, Seok Ho Dong, Hyo Jong Kim, Young Woon Chang, Rin Chang
• Journal: The Korean journal of hepatology (Korean J Hepatol) Vol. 13 Issue 2 Pg. 185-95 (Jun 2007) ISSN: 1738-222X [Print] Korea (South)
• PMID: 17585192 (Publication Type: English Abstract, Journal Article)

Chemical References

• Adenosine Deaminase

Topics

• Adenosine Deaminase (analysis)
• Adult
• Aged
• Ascitic Fluid (chemistry, pathology)
• Female
• Humans
• Liver Cirrhosis (diagnosis, epidemiology, etiology)
• Liver Cirrhosis, Alcoholic (diagnosis, epidemiology)
• Male
• Middle Aged
• Neoplasms (diagnosis, epidemiology, etiology)
• Paracentesis
• Peritonitis, Tuberculous (diagnosis, epidemiology)
• Predictive Value of Tests
• Prevalence
• Retrospective Studies