Ultrasonography as a diagnostic aid for determining etiology of ascites

Aim: This study will be done to evaluate and determine the cause of ascites using USG meanwhile using laboratory paracentesis as a reference. Materials and methods: The study will be conducted in the department of Radio-Diagnosis and Imaging in co-ordination with the department of Medicine and department of Pathology at Acharya Shri Chander College of Medical Sciences and Hospital, Sidhra, Jammu. A total of 50 patients will be included in this study irrespective of the gender. Scanning technique of abdominal and pelvic ultrasound: All the US examinations will be performed using LOGIC C5 PREMIUM following a fasting period of atleast 4 hours. The results of the evaluation will be recorded on standardized proforma. Existence of septa-debris, accompanying organ pathology, omental involvement, intestinal wall thickening, peritoneal implants, lymph node, diameter of portal vein, thickening of gall bladder wall, pleural effusion, collateral vascular structure and cavernous transformation will be investigated on USG. Result of biopsy or surgical intervention will be regarded as the gold standard for the pathological diagnosis in all cases. Informed consent will be obtained from each patient. Immediately after the ultrasound examination within an average of 14 minutes interval), US guided paracentesis will be done under sterile conditions. Blood sample will also be drawn immediately after the paracentesis. The ascitic fluid and blood samples will be sent to the laboratory to determine ascitic albumin, cell count and differential as well as serum albumin and total protein. A portion of ascitic fluid sample will also be sent to the pathology unit for cytology. The serum and ascitic albumin values will be used to determine the serum ascites albumin gradient (SAAG). Results: In this study, a total of 50 patients with ascites will be included. In the present study, the age of the patients ranged from 05 years to 67 years. The mean age will be 48 years. The maximum number of patients 37 (74%) will be in the age group of 31-60 years. Out of 50 cases 39 (78%) will be supposedly having benign ascites and 11 (22%) malignant ascites.