Gastroenterology & Hepatology · NEET PG Preparation Medicine
A 50-year-old male is evaluated for refractory ascites. Paracentesis is performed, and ascitic fluid analysis shows a serum-ascites albumin gradient…
Practice question from Gastroenterology & Hepatology (NEET PG Preparation Medicine), with the correct answer and a step-by-step solution.
medium · MCQ · Q-2CB12B
A 50-year-old male is evaluated for refractory ascites. Paracentesis is performed, and ascitic fluid analysis shows a serum-ascites albumin gradient (SAAG) of 1.6 g/dL and an ascitic fluid total protein of 2.8 g/dL. Which of the following is the most likely underlying cause of ascites in this patient?
- A.Cardiac ascites (e.g., constrictive pericarditis or heart failure)Correct answer
- B.Cirrhosis of the liver
- C.Spontaneous bacterial peritonitis
- D.Tuberculous peritonitis
Solution
A SAAG >= 1.1 g/dL indicates portal hypertension. When the ascitic fluid total protein is high (>= 2.5 g/dL), the cause of portal hypertension is typically pre-sinusoidal or post-sinusoidal, most commonly cardiac causes such as right-sided heart failure or constrictive pericarditis. In cirrhosis (hepatic portal hypertension), ascitic fluid protein is typically low (< 2.5 g/dL).
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