Nasir Hassan Luck, Anwaar A Khan, Altaf Alam, Arshad Kamal Butt, Farzana Shafquat.
Role of Laparoscopy in the diagnosis of low serum ascites albumin gradient
J Pak Med Assoc Jan 2007;57(1):33-4.
Sheikh Zayed Hospital Complex, F.P.G.M.I, Lahore

The objective is to determine causes of low serum ascites albumin gradient (SAAG) by direct visualization and obtaining biopsy samples using laparoscopic technique. This is a. hospital - based, observational study conducted at Department of Gastroenterology, Sheikh Zayed Hospital, Lahore from January 2001 to April 2002. A total of 33 patients with ascites (SAAG< 1.1 g/dl)) were selected. The findings on history and clinical examination, information from laboratory and radiological investigations were recorded. Laparoscopic findings and histological reporting were correlated. The mean ages were 48.38 ±16.7 years. Fifteen (45%) patients were male. The mean duration of the presenting complaints was 3.33 ± 1.9 months. Ascites was present in all with mean SAAG of 0.73 ± 0.22. Laparoscopic evaluation showed tuberculous peritonitis in 22 (66.7%) patients and carcinomatous peritonitis in 5 (15.2%) patients. Biopsies were obtained from omentum in 20, peritoneal surface in 5 and liver in 12 patients. The histopathological diagnosis was granulomatous inflammation in 20(60.6%) and diagnosis of malignancy was made in 7(21.2%); one (3%) had Budd Chiari Syndrome, 4(12%) had cirrhosis of liver with super-added Hepatocellular carcinoma and biopsy was non -conclusive in 1 patient. No complication of procedure occurred in this cohort. Laparoscopy is a safe diagnostic modality to establish the cause of low SAAG ascites.

Category: Internal Medicine
Keywords: Laparoscopy. Ascites. Albumin. Portal Hypertension. Cirrhosis. Tuberculosis. Peritonitis.

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