Exudative Versus Transudative Ascites: The Role of Abdominal Ultrasonography in Differentiation in Comparison to Conventional Methods

Abstract

Ultrasonography is sensitive and specific method for detection of ascites. It can detect little amount of ascitic fluid that can not be detected clinically. In the same time, it can help in determining the nature of ascitic fluid (Evens, 1991).

In this study, real time abdominal sonography was performed in 150 patients with ascites, 98 (65.3%) patient with transudative and 52 (34.7%) with exudative ascites, to evaluate the ability ofsonography in differentiating an exudative from transudative collection. The echogenicity of ascites was graded into I, II and III using the echogenicity of normal abdominal viscera as a comparative standard reference points.

• Grade I collections (92, 61.3% patients) were either absolutely anechioc or showed few internal echoes.

• Grade II collections (57, 38% patients) were hypoechoic as compared to abdominal viscera.

• Grade III collection (1, 0.7% patient) had an echogenicity similar to the abdominal viscera. It