Comparative utility of sero ascites albumin gradient and ascitic fluid total protein for differential diagnosis of ascites.

Ascites can be defined as the abnormal accumulation of fluid inside the peritoneal cavity. Earlier ascites was classified as transudative and exudative based on the total protein concentration of the ascitic fluid. The traditional concept of high protein ascites(> 2.5 g/dl) as exudate was questioned because: (a) the normal peritoneal fluid protein concentration is some times > 4 g/dl(1); (b) the ascitic fluid protein concentration increases in cirrhotic patients with diuresis and albumin infusion^); (c) some transudative ascites like cardiac ascites have high protein concentration while some traditionally exudative ascites like malignant ascites have low concentration of protein(3); and (d) moreover cirrhosis may be the most frequent cause of high protein ascites(4).