Etiologic and Laboratory Analyses of Ascites in Patients who Underwent Diagnostic Paracentesis.
- Author:
Young HWANGBO
1
;
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
Author Information
1. Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea. kimbh@khu.ac.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Ascites;
Etiology;
Epidemiology;
Diagnosis;
Korea
- MeSH:
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
- From:The Korean Journal of Hepatology
2007;13(2):185-195
- CountryRepublic of Korea
- Language:Korean
-
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.
