Ascites causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: M.Umer Tariq [2]

Causes

Common Causes

Causes of high SAAG ("transudate") are:

• Cirrhosis - 81% (alcoholic in 65%, viral in 10%, cryptogenic in 6%)
• Heart failure - 3%
• Budd-Chiari syndrome or veno-occlusive disease
• Constrictive pericarditis

Causes of low SAAG ("exudate") are:

• Cancer (primary peritoneal carcinomatosis and metastasis) - 10%
• Tuberculosis - 2%
• Pancreatitis - 1%
• Serositis
• Nephrotic syndrome

Causes by Organ System

Cardiovascular	Budd-Chiari syndrome, Cardiac amyloidosis, Cardiac failure, right sided, Cholesterol pericarditis, Congestive Heart Failure, Constrictive pericarditis, Obstruction of the inferior vena cava, Tricuspid insufficiency, Veno-occlusive disease
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	Ovarian hyperstimulation syndrome
Environmental	No underlying causes
Gastroenterologic	Acute liver failure, Acute pancreatitis, Alcoholic hepatitis, Alcoholic liver disease, Biliary fistula, Cholangiocarcinoma, Chronic hepatitis, Cirrhosis, Hepatic failure, Hepato-biliary diseases, Ménétrier's disease, Nutmeg liver, Pancreatic fistula, Peritonitis, Portal hypertension, Portal vein occlusion
Genetic	No underlying causes
Hematologic	Banti's syndrome, Haemochromatosis, Intestinal lymphatic blockage, Turner's syndrome
Iatrogenic	No underlying causes
Infectious Disease	Alveolar hydatid disease, Bacterial peritonitis, Dengue fever, Fasciolopsiasis, Fasciolosis, Hepatitis C, Hookworm
Musculoskeletal / Ortho	No underlying causes
Neurologic	No underlying causes
Nutritional / Metabolic	Hypoalbuminemia, Kwashiorkor, Wilson's Disease
Obstetric/Gynecologic	Meigs' syndrome, Mirror syndrome
Oncologic	Angioimmunoblastic T-cell lymphoma, Desmoplastic small round cell tumor, Malignancy, Ovarian cancer
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Pulmonary hypertension
Renal / Electrolyte	Hepatorenal syndrome, Nephrotic syndrome
Rheum / Immune / Allergy	Eosinophilic gastroenteritis, Eosinophilic peritonitis, Primary biliary cirrhosis
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	Hypervolemia, Idiopathic, Obesity hypoventilation syndrome, POEMS syndrome

Causes in Alphabetical Order

Acute liver failure Acute pancreatitis Alcoholic hepatitis Alcoholic liver disease Alveolar hydatid disease Angioimmunoblastic T-cell lymphoma Bacterial peritonitis Banti's syndrome Biliary fistula Budd-Chiari syndrome Cardiac amyloidosis Cardiac failure, right sided Cholangiocarcinoma Cholesterol pericarditis Chronic hepatitis Chylous ascites Cirrhosis Congestive Heart Failure Constrictive pericarditis Dengue fever Desmoplastic small round cell tumor Eosinophilic gastroenteritis Eosinophilic peritonitis Fasciolopsiasis Fasciolosis Haemochromatosis Hepatic failure Hepatic vein thrombosis Hepatitis C

Hepato-biliary diseases Hepatorenal syndrome Hookworm Hypervolemia Hypoalbuminemia Idiopathic Intestinal lymphatic blockage Kwashiorkor Malignancy Meigs' syndrome Ménétrier's disease Mirror syndrome Nephrotic syndrome Nutmeg liver Obesity hypoventilation syndrome Obstruction of the inferior vena cava Ovarian cancer Ovarian hyperstimulation syndrome Pancreatic fistula Peritonitis POEMS syndrome Portal hypertension Portal vein occlusion Primary biliary cirrhosis Pulmonary hypertension Trauma Tricuspid insufficiency Turner's syndrome Veno-occlusive disease Wilson's Disease

Fetal Ascites

Differential diagnosis of fetal ascites include:

• Urinary ascites
• Bowel rupture (i.e. meconium peritonitis)
• Ruptured ovarian cyst
• Hydrops
• Pseudoascites
• Infection