Ascites differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]

Differentiating Other Diseases Caused Ascites

• Diseases that cause ascites should differentiate from each others, such as cirrhosis, Alcoholic hepatitis, Budd-Chiari syndrome, Constrictive pericarditis, Heart failure, Myxedema, Cancer, Nephrotic syndrome, Pancreatitis, Serositis, and Tuberculosis.
• The ascites may be transudate (serum-ascites albumin gradient [SAAG] ≥ 1.1 g/dL) or exudate (serum-ascites albumin gradient [SAAG] < 1.1 g/dL).

Type	Diseases	History and Symptoms								Physical Examination						Laboratory Findings							Other Findings
		GI symptoms				Extra-GI symptoms										Liver function test				Biochemical test
		Jaundice	Abdominal pain	Hematemesis	Nausea	Weight loss	Dyspnea	Cough	Chest pain	Fever	Spider angioma	Abdominal tenderness	Jugular venous distention	Pitting edema	Muffled heart sounds	ALT	AST	Bili	Amylase /Lipase	Cr	ESR	Na-K
Transudate (SAAG≥ 1.1g/dL)	Cirrhosis					+
	Alcoholic hepatitis	↑					-
	Budd-Chiari syndrome		↓
	Constrictive pericarditis
	Heart failure
	Myxedema
	Portal hypertension
Exudate (SAAG< 1.1g/dL)	Cancer
	Nephrotic syndrome
	Pancreatitis
	Serositis
	Tuberculosis