The Role of Ascitic Fluid Viscosity in the Differential Diagnosis of Ascites

Abstract

The measurement of ascitic fluid viscosity correlates significantly with SAAG values. In view of its simplicity, low cost, small sample volume requirement and allowance for measurement in previously frozen samples, measurement of ascites viscosity could be useful for the accurate and rapid classification of ascites.

Review article: the diagnostic approach and current management of chylous ascites

“…A triglyceride concentration above 200 mg/dL supports the diagnosis of chylous ascites, while a level less than 50 mg/dL excludes it . The macroscopic appearance of chylous ascites is turbid and thick compared to the straw‐colored, transparent ascitic fluid seen in portal hypertension . Microscopic examination of the fluid stained with Sudan III shows fat globules and leucocytes with a lymphocytic predominance.…”

Ascitic Fluid Analysis in the Differential Diagnosis of Ascites: Focus on Cirrhotic Ascites

“… 2 According to Gokturk et al ., LDH values were higher in patients with an SAAG of 1.1 g/dL or less than in those with an SAAG greater than 1.1 g/dL. 37 However, Sevinc et al . reported that in patients with malignant ascites, ascitic fluid LDH values had high sensitivity but low specificity for the diagnosis of the disease, and a low value of LDH did not necessarily exclude malignancy.…”

“… 42 However, when considering the value of glucose in patients with SAAG greater or less than 1.1 g/dL, there was no significant difference between them. 37 Therefore, due to its low diagnostic sensitivity and specificity, the application of ascitic glucose analysis is limited in routine practice. 43 …”

“…evaluated the role of ascitic fluid viscosity in discriminating between ascites due to portal hypertension-related and non-portal hypertension-related causes, and compared the results with SAAG. 37 In that study, ascitic fluid viscosity was determined in a programmable rotational viscometer using 0.5 mL ascitic samples from 142 patients with newly diagnosed ascites due to various causes. 37 The mean ascitic fluid viscosities were 0.86±0.12 cP and 1.22±0.25 cP in patients with an SAAG greater than 11 g/L and an SAAG of 11g/L or less, respectively, indicating a close correlation between viscosity and SAAG.…”

“… 37 In that study, ascitic fluid viscosity was determined in a programmable rotational viscometer using 0.5 mL ascitic samples from 142 patients with newly diagnosed ascites due to various causes. 37 The mean ascitic fluid viscosities were 0.86±0.12 cP and 1.22±0.25 cP in patients with an SAAG greater than 11 g/L and an SAAG of 11g/L or less, respectively, indicating a close correlation between viscosity and SAAG. Moreover, with a cut-off value of 1.03 cP, ascitic fluid viscosity measurement exhibited high sensitivity (98%), specificity (80%), and positive and negative predictive values (79% and 94%, respectively) for the etiological discrimination of ascites.…”