الفهرس 
causes and diagnosis of ascitOnly 14 pages are availabe for public view
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Abstract
Background: Ascites is a common clinical condition encountered by
physicians in day-to-day clinical practice. It is caused by various diseases.
Knowing the etiologies is vital for prognosis and proper management.
Numerous diagnostic parameters have been studied, but no single parameter
has completely distinguished these.
Aim of the work: to assess the validaty of the Egyptian club of ascites
(ECA) diagnostic approach to reach diagnosis of ascites in patients in
Fayoum governorate.
Patients and methods: A cross sectional study was performed on one
hundred randomized patients with un-investigated ascites.They were
subjected to complet clinical evaluation and diagnostic paracentesis. They
were tested for ascitic fluid total leucocytic count with differential (TLC),
total protein (AFTP) and serum ascitic albumin gradient (SAAG). Other
tests were restricted to specific diagnostic queries.
Results: one hundred patients were evaluated, of whom 57(57%) were men,
with an average age of 57.44±10.5years. Ninty-one (91%) were diagnosed
with Portal hypertensive (PHT) related ascites and 11 (11%) with non-PHT
related ascites. Hepatits C virus (HCV) related liver cirrosis (LC) was
commonest cause of ascites (78%). SAAG correctly classified 87 (95.6%)
patients, but 4 (4.4%) were classified incorrectly, while AFTP classified 86
(94.5%) correctly and only 5 (5.5%) incorrectly. Sensitivity, Specificty and
diagnostic accuracy for SAAG were 96.7%,100% and 98.4 versus 94.6%,
100% and 97.3% respectively for AFTP.
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Conclusions: ECA approach could be used in clinical practice to achieve a
more accurate diagnostic approach. SAAG and AFTP had high diagnostic
accuracy in diagnosis of ascites.
Key words: Ascites , SAAG, AFTP, PHT, ECA, Liver cirrhosis.