A Study on Etiology of Ascites in a Tertiary Care Hospital

BACKGROUND : Ascites describes the condition of pathologic fluid collection within the abdominal cavity. The word ascites is of Greek origin (askos) and means bag or sac.There are numerous causes of ascites of which common ones are cirrhosis liver, malignancy, tuberculosis, cardiac failure, pancreatitis and nephrotic syndrome. This study has been done to screen the etiology of ascites in patients admitted with ascites in our hospital between October 2012 and August 2014. OBJECTIVE :  To study the etiology of patients presenting with ascites who were admitted in medical wards and ICU between October2012 and August, 2014. MATERIALS AND METHODS : A prospective, Observational study of 200 patients admitted with ascites in medical wards and ICU between October 2012 and August2014 in our hospital.Inclusion criteria wereage of patients above 18 years and ascites confirmed by clinical and ultrasound examination. Exclusion criteria were pregnancy and those who have underwent recent surgery i.e within three months.All patients who fulfilled the inclusion criteria were thoroughly evaluated with a detailed history, physical examination and appropriate investigations. All patients with ascites,after confirmation by USG underwent abdominal paracentesis to ascertain the cause of ascites RESULTS AND DISCUSSION : In our study the most common cause of ascites was Chronic Liver disease (90%).The remaining causes were malignancy (4.5%), pancreatitis (2.5%), tuberculosis (2%) and cardiac failure (1%). Among chronic liver disease,ethanol related was 60%, HBV related was 18.5%, cryptogenic 6.5%, HCV related was 3.5% and autoimmune etiology was 1.5% respectively. The distribution in malignancy related was hepatocellular carcinoma (22.2%), carcinoma ovary (22.2%),pancreatic carcinoma(11.1%), carcinoma colon (11.1%),gastric carcinoma (11.1%), carcinoma GE junction(11.1%) and primary peritoneal carcinomatosis(11.1%).