Utilization of serum-ascites albumin gradient (SAAG) can guide specific investigations for children with unclear etiology of ascites.
Clinical history with the utilization of SAAG and ascitic fluid total protein (AFTP) may help in differential diagnosis of ascites.
High SAAG may predict the severity of portal hypertension and gastrointestinal bleeding from esophageal varices.
Abdominal paracentesis is performed as a diagnostic test in children with ascites. Serum albumin to ascitic fluid albumin gradient (SAAG) is frequently used in adults to distinguish types of portal hypertension. We aim to investigate the utilization of SAAG and other biomarkers in determining the etiology of significant ascites in children.
In this retrospective study, children aged 0–21 years with significant ascites were identified using International Classification of Diseases, Ninth Revision (ICD-9) codes and medical records during the period 1983–2010. Medical records of children who had abdominal paracentesis were examined in detail.
207 children had significant ascites and of those children, 20 (9.6%) had abdominal paracentesis. Our data showed that high albumin gradient (SAAG ≥ 1.1 g/dL) differentiates causes of ascites secondary to portal hypertension (cirrhosis, hepatic vein outflow obstruction, or congestive hepatopathy) from other causes. In addition, ascitic fluid total protein (AFTP) may help in differential diagnosis of ascites. Children with high SAAG manifest clinical features of portal hypertension including esophageal varices or variceal hemorrhage.
Among patients with initially unclear causes of ascites, SAAG and AFTP can provide guidance for appropriate investigations.Le texte complet de cet article est disponible en PDF.
Keywords : Paracentesis, Portal hypertension, Liver cirrhosis, Exudates and transudates