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General clinical study of fluid from the abdominal cavity
Last reviewed: 23.04.2024
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In healthy people in the abdominal cavity between the leaves of the peritoneum contains a small amount of fluid. In a number of diseases (cirrhosis of the liver, heart failure), the amount of ascitic fluid can be significant and reach several liters, this fluid belongs to transudates and has all its signs. Hemorrhagic exudate is found in cancerous and, more rarely, tubercular peritonitis, trauma, strangulated hernia, hemorrhagic diathesis, peritoneal melanosarcoma, and sometimes cirrhosis of the liver. In cases of perforation of the intestine, gall bladder, the contents of the abdominal cavity may contain an admixture of bile.
For the differential diagnosis of ascites due to malignant neoplasms and ascites in chronic liver diseases, an albumin gradient is used (the difference between the concentration of albumin in the blood serum and that of the ascitic fluid). If it is lower than 1,1, then in more than 90% of cases ascites is associated with carcinomatosis or tuberculosis of the peritoneum, pancreatitis or diseases of the bile duct, nephrotic syndrome, intestinal infarction or intestinal obstruction, serositis. The albumin gradient is almost always above 1.1 for liver cirrhosis, alcoholic hepatitis, massive liver metastases, fulminant hepatic insufficiency, portal thrombosis, heart failure, fatty hepatosis of pregnant women, myxedema.
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