The Value of Ultrasound in Characterizing and Determining the Etiology of Ascites

Abstract

BACKGROUND: The aim of this study was to assess the role oftransabdominal ultrasonography in characterizing anddetermining the etiology of ascites in comparison with laboratoryascitic fluid analysis and other methods used to establish the finaldiagnosis.

METHODS: A prospective descriptive study was conducted on 61patients with ascites attending outpatient department (OPD) oradmitted to wards of Tikur Anbesa Specialized Hospital (TASH)and referred to radiology department for imaging from June 2017to November 2017. Data were collected following theinternationally recommended scanning technique in consecutivebases. The data were analyzed using SPSS version 20. Thecomparison of ultrasound and laboratory findings with finalclinical diagnosis was analyzed using Chi-square test (X 2 ).

RESULTS: Of 61 patients with ascites enrolled in this study,females were 35(57.4%) with age range of 16 to 75 and mean ageof 43.2±14.11. The cause of ascites was established in 59 casesusing a combination of clinical, pathological, imaging evidencesand tumor markers. However there were two cases who had asciteswith indeterminate cause. US suggested the diagnosis in54(91.5%) patients. Excluding mixed and indeterminate cases,ultrasound characterized ascites correctly as exudate andtransudate in 95% cases.

CONCLUSION: Ultrasound has significant accuracy todistinguish transudate and exudate ascites and in suggesting theunderlying cause. It can be a valuable method of investigation ofascites in places where CT and MRI are not available, and it is thebest complement for laboratory investigations on ascites insuggesting the etiology based on ascitic fluid texture and ancillaryfindings.