What are Albumin - Ascitic fluid?

Ascites are the accumulation of ascitic fluid in the peritoneal cavity.
Many diseases can cause ascites, but the most common cause is portal hypertension, which is usually due to liver cirrhosis.
Ascites do not typically become clinically detectable until there are at least 500mLs of fluid present.

If large amounts of fluid accumulate, the abdomen can become very distended and tense, causing the patient to feel short of breath (due to diaphragmatic splinting).
Analysis of ascitic fluid can help determine the underlying cause and identify signs of infection.

A sample of fluid is typically obtained using a needle and syringe (known as an “ascitic tap” or “paracentesis”) and sent for analysis.
The peritoneum is a tough semi-permeable membrane lining abdominal and visceral cavities. it encloses, supports and lubricates organs within the cavity. Paracentesis is effectively the analysis of ‘Ascites’ – the abnormal accumulation of fluid within the abdomen.

• The peritoneum is important in osmoregulation
  • Passive diffusion of water and solute (up to a certain size)
  • Maintains osmotic and chemical equilibrium with blood and lymph
• Ascites develops either from:
  • Increased accumulation
    • Increased capillary permeability
    • Increased venous pressure
    • Decreased protein (oncotic pressure)
  • Decreased clearance
  • Increased lymphatic obstruction

Clinical features of ascites

Typical clinical features of ascites include:

• Abdominal distension
• Abdominal discomfort
• Weight gain
• Shortness of breath
• Reduced appetite

Cause

• Transudate (<30g/L protein) (Systemic disease)
• Liver (Cirrhosis)
• Cardiac e.g. RHF, CCF, SBE right heart valve disease and constrictive Pericarditis
• Renal failure
• Hypoalbuminaemia (nephrosis)
• Exudate (>30g/L protein) (Local disease)
• Malignancy
• Venous obstruction e.g. Budd-Chiari, Schistosomiasis
• Pancreatitis
• Lymphatic obstruction
• Infection (especially TB)