Journal of Clinical Chemistry and Laboratory Medicine
Open Access

A Note on Ascitic Fluid Analysis (AFA)

Alexander Otsetov^{* *}Correspondence: Alexander Otsetov, Department of Laboratory Medicine, Umeå University, Umeå, Sweden,

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Description

Ascites is the accumulation of ascitic fluid in the peritoneal cavity. Numerous diseases can cause ascites; however the most widely recognized reason is portal hypertension, which is typically because of liver cirrhosis. Ascites doesn't normally turn out to be clinically perceptible until there is at least 500 mLs of fluid present. In case of large amount of fluid accumulation, the abdomen can turn out to be exceptionally enlarged and tense, making the patient feel shortness of breath (due to diaphragmatic bracing). Ascitic fluid analysis can assist with deciding the fundamental reason and recognize indications of infection. A sample of fluid is determined by using a needle and syringe (known as an "ascitic tap" or "paracentesis") and sent for investigation/analysis. Biochemical analysis of ascitic liquid can give valuable insight which can assist with limiting the differential conclusion. Ascitic liquid microscopy gives important data about the number and patterns of red and white cells inside the fluid which can assist with restricting the underlying disease [1,2].

The Serum Ascitic Albumin Gradient (SAAG) can determine whether ascites is caused due to portal hypertension;

SAAG=(serum albumin)-(ascetic fluid albumin)

The peritoneum is an intense semi-permeable membrane lining stomach and visceral cavities. It encases, upholds and lubricates organs present inside the cavity. Paracentesis is adequately the examination of 'Ascites'-the unusual aggregation of fluid inside the abdomen. Under typical conditions, the measure of peritoneal fluid relies upon a balance between flow of plasma in and out of the blood and lymphatic vessels. It is just when this equilibrium has been disturbed does ascites form. The imbalance in the degree of plasma might be because of increase in capillary permeability, increased pressure in vein, diminished protein (oncotic pressure), or lymphatic obstruction. The underlying assessment of the gross appearance of ascitic fluid can offer valuable data in the differential diagnosis. Under normal conditions, peritoneal fluid is clear to light yellow [3,4].

Conclusion

Ascites can be an outcome of numerous essential diseases and conveys a negative anticipation that generally relies upon the basic causes. Cirrhotic ascites represents most instances of ascites, and it tends to be convoluted by resulting diseases that likewise lead to ascites. Ascitic fluid analysis showing gross appearance, biochemical tests (for example SAAG, LDH, glucose, amylase, and ADA), and non-biochemical tests (for example cell counts, bacterial culture and PCR, thickness, 1H NMR spectroscopy, VEGF, and growth markers) can give valuable insights in the differential conclusion of ascites and help in building up an analysis. It ought to be underlined that doctors should utilize the ascitic liquid investigation in blend with clinical and imaging information, to make a precise finding of the reason for ascites.

References

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2. Tarn AC, Lapworth R. Biochemical analysis of ascitic (peritoneal) fluid: what should we measure? Ann Clin Biochem. 2010;47(Pt 5):397-407.
3. Atkinson M, Losowsky MS. The mechanism of ascites formation in chronic liver disease. QJM-Int J Med. 1961;30(2):153-166.
4. Biecker E. Diagnosis and therapy of ascites in liver cirrhosis. World J Gastroenterol. 2011;17(10):1237-1248.