Aim: The aim of the present study was to examine the role of biochemical testing in diagnosing the cause of ascitic fluid accumulation. Methods: The observational hospital-based study was carried on 200 indoor patients who were diagnosed as ascites on the basis of history, physical examination, ultrasonography, and of age >18 years were included in the study after getting the informed consent. Data was taken from medical records department. Patients who had a diagnostic paracentesis within 2 weeks (cause was already established), secondary cause of peritonitis and unwilling to participate in the study were excluded. Results: This study included 200 patients with age ranging from 20 to 78 years and majority of patients were aged between 41-50 years (n=50, 25%), only 20 patients 10% admitted with ascites of the age group between 18-30 years. The most common clinical feature was abdominal discomfort, followed by Anorexia, Icterus, Splenomegaly and Hepatomegaly. The most common etiology of Ascites was Liver cirrhosis (40%), followed by Tuberculosis (32%) then Malignancy (9%), and Congestive Heart Failure (6%). 80 of the 120 exudates were detected using the traditional cutoff for cell count greater than 500/mm3, but using the cutoff proposed in the present paper (300 cells/mm3), the detection increased to 98/120. Of the biochemical parameters studied, the AST ratio AF/S (> 0.5) detected the greater number of exudates correctly classified 96/120, while 14 of 80 transudates were falsely classified. Conclusion: Ascites due to chronic liver disease was the main finding with etiology supported by laboratory findings. Biochemical testing of peritoneal and pleural fluids is carried out widely, although the range of tests likely to be useful is limited in comparison to the repertoire of tests available in a modern biochemistry laboratory.

Aim: The aim of the present study was to examine the role of biochemical testing in diagnosing the cause of ascitic fluid accumulation. Methods: The observational hospital-based study was carried on 200 indoor patients who were diagnosed as ascites on the basis of history, physical examination, ultrasonography, and of age >18 years were included in the study after getting the informed consent. Data was taken from medical records department. Patients who had a diagnostic paracentesis within 2 weeks (cause was already established), secondary cause of peritonitis and unwilling to participate in the study were excluded. Results: This study included 200 patients with age ranging from 20 to 78 years and majority of patients were aged between 41-50 years (n=50, 25%), only 20 patients 10% admitted with ascites of the age group between 18-30 years. The most common clinical feature was abdominal discomfort, followed by Anorexia, Icterus, Splenomegaly and Hepatomegaly. The most common etiology of Ascites was Liver cirrhosis (40%), followed by Tuberculosis (32%) then Malignancy (9%), and Congestive Heart Failure (6%). 80 of the 120 exudates were detected using the traditional cutoff for cell count greater than 500/mm3, but using the cutoff proposed in the present paper (300 cells/mm3), the detection increased to 98/120. Of the biochemical parameters studied, the AST ratio AF/S (> 0.5) detected the greater number of exudates correctly classified 96/120, while 14 of 80 transudates were falsely classified. Conclusion: Ascites due to chronic liver disease was the main finding with etiology supported by laboratory findings. Biochemical testing of peritoneal and pleural fluids is carried out widely, although the range of tests likely to be useful is limited in comparison to the repertoire of tests available in a modern biochemistry laboratory.