Ibrahim, I., Elsaid, E., Dina, N., Hanaa, E., Sameh, A. (2020). Frequency and characterization of mixed ascites among cirrhotic patients admitted to Zagazig University hospital. Medical Journal of Viral Hepatitis, 4.2(2), 75-80. doi: 10.21608/mjvh.2020.80657
Ibrahim Ibrahim; Elbadrawy Elsaid; Nasr Dina; El-Said Hanaa; Abdel Monem Sameh. "Frequency and characterization of mixed ascites among cirrhotic patients admitted to Zagazig University hospital". Medical Journal of Viral Hepatitis, 4.2, 2, 2020, 75-80. doi: 10.21608/mjvh.2020.80657
Ibrahim, I., Elsaid, E., Dina, N., Hanaa, E., Sameh, A. (2020). 'Frequency and characterization of mixed ascites among cirrhotic patients admitted to Zagazig University hospital', Medical Journal of Viral Hepatitis, 4.2(2), pp. 75-80. doi: 10.21608/mjvh.2020.80657
Ibrahim, I., Elsaid, E., Dina, N., Hanaa, E., Sameh, A. Frequency and characterization of mixed ascites among cirrhotic patients admitted to Zagazig University hospital. Medical Journal of Viral Hepatitis, 2020; 4.2(2): 75-80. doi: 10.21608/mjvh.2020.80657
Frequency and characterization of mixed ascites among cirrhotic patients admitted to Zagazig University hospital
1Tropical Medicine dept., Faculty of Medicine, Zagazig Univ., Zagazig, Egypt
2Clinical Pathology dept., Faculty of Medicine, Zagazig Univ., Zagazig, Egypt
Abstract
Background and aim. Mixed ascites is defined in patients in whom two or more etiologies of ascites are demonstrated. Such patients have liver cirrhosis plus (an) other local and/or systemic cause(s). The aimof this work is to detect the frequency and characterization of mixed ascites among cirrhotic patients. Patients and methods. The study was conducted on 273 ascitic cirrhotic patients. All patients were subjected to full history taking, thorough clinical examination, radiological investigations and laboratory investigations including CRP and tumor markers (AFP, CEA, CA 19-9, CA 125). Diagnostic abdominal paracentesis with cytologic and biochemical analyses and Ziehl- Neelsen staining of ascitic fluid were done. Also, serum-ascites albumin gradient (SAAG) was calculated. Results. Twenty eight patients (10.3%) among the studied patients were mixed ascites. Among patients with mixed ascites, the most common cause was malignancy in 11 patients (39.2%), cardiac causes were present in 7 patients (25%), renal causes were found in 2 patients (7.1%) and surgical abdominal causes were present in 8 patients (28.7%). Compared to non-mixed ascites, patients with mixed ascites had a statistically significant increase regarding ascitic total leucocytic count, SAAG, glucose, lactate dehydrogenase and protein. Moreover, there was a significant increase in tumor markers and CRP in patients with mixed ascites versus patients with non-mixed ascites. Using logistic regression analysis, the predictor variables for mixed ascites in cirrhotic patients included positive tumor markers CEA and CA 19-9 and positive CRP. Conclusion. in our study, the commonest cause of mixed ascites was malignancy. Significant predictors of mixed ascites were CRP and tumor markers; CEA, CA 19-9 and CA 125.
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