Frequency and characterization of mixed ascites among cirrhotic patients admitted to Zagazig University hospital

Abstract

Background and aim. Mixed ascites is defined in patients in whom two or more etiologies of ascites are demonstrated. Such patients have liver cirrhosis plus (an) other local and/or systemic cause(s). The aim of this work is to detect the frequency and characterization of mixed ascites among cirrhotic patients. Patients and methods.The study was conducted on 273 ascitic cirrhotic patients. All patients were subjected to full history taking, thorough clinical examination, radiological investigations and laboratory investigations including CRP and tumor markers (AFP, CEA, CA 19-9, CA 125). Diagnostic abdominal paracentesis with cytologic and biochemical analyses and Ziehl-Neelsen staining of ascitic fluid were done. Also, serum-ascites albumin gradient (SAAG) was calculated. Results. Twenty eight patients (10.3%) among the studied patients were mixed ascites. Among patients with mixed ascites, the most common cause was malignancy in 11 patients (39.2%), cardiac causes were present in 7 patients (25%), renal causes were found in 2 patients (7.1%) and surgical abdominal causes were present in 8 patients (28.7%). Compared to non-mixed ascites, patients with mixed ascites had a statistically significant increase regarding ascitic total leucocytic count, lactate dehydrogenase and protein. Moreover, there was a significant increase in tumor markers and CRP in patients with mixed ascites versus patients with non-mixed ascites. Using logistic regression analysis, the predictor variables for mixed ascites in cirrhotic patients included positive tumor markers CEA and CA 19-9 and positive CRP. Conclusion. in our study, the commonest cause of mixed ascites was malignancy. Significant predictors of mixed ascites were CRP and tumor markers; CEA, CA 19-9 and CA 125.

Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter study

“…Cirrhosis is a leading cause of death in many countries. Portal hypertension in the setting of liver cirrhosis is estimated to be the source of around 75% of cases of ascites, with the remaining instances arising from infectious, inflammatory, and infiltrative causes [ 1 – 6 ].…”

A Novel risk score to predict first attack of esophageal variceal bleeding in cirrhotic patients

“…Chronic liver cirrhosis is characterised by signi cant hemodynamic abnormalities, particularly in advanced cirrhosis, including portal hypertension. Portal hypertension is the key reason for the majority of complications in patients with cirrhosis, including gastrointestinal bleeding from rupture of varices, hepatic encephalopathy, and ascites [1][2][3][4][5][6] . One of the most austere consequences of portal hypertension is the development of esophageal varices (EV) 7 .…”

Diagnostic utility of absolute neutrophil count as a new marker of spontaneous bacterial peritonitis; multicenter study

“…Although many pathogenic processes have been implicated in the development of ascites, about 75% likely occur as a result of portal hypertension in the setting of liver cirrhosis with the remainder due to infectious, inflammatory and infiltrative conditions. [1][2][3][4][5][6] In cirrhotic patients, bacterial infection increases the morbidity and mortality. [7][8][9] Spontaneous bacterial peritonitis (SBP) is a risky complication that occurs amongst cirrhotic patients with ascites.…”