Ascites - Diagnosis

What kinds of tests or exams led to a diagnosis of ascites?

Share your story with others:

MedicineNet appreciates your comment. Your comment may be displayed on the site and will always be published anonymously.Patient Comments FAQs

Enter your Comment

Tell us a bit about your background to make your comments more useful to other MedicineNet users. (Optional)

Screen Name: *

Gender of Patient: Male Female

Age Range of Patient:

I am a: Patient Caregiver


* Screen Name will appear next to the published comment. Please do not include your full name or email address.

By submitting your comment, and other materials (collectively referred to as a "Submission") to MedicineNet, you grant MedicineNet permission to use, copy, transmit, publish, display, edit and modify your Submission in connection with its Web site. MedicineNet will not pay you for your Submission. You represent that you have all rights necessary for MedicineNet to use your Submission as set forth above.

Please keep these guidelines in mind when writing your comment:

  • Please make sure you address the question asked.
  • Due to the overwhelming number of comments received, not all comments will be published.
  • When selecting comments to publish, our staff will choose those that are educational and complement the topic. Please try to stay on topic.
  • Your comment may be edited. We would typically edit comments to make them clearer and more readable. We will remove personal information such as last names, email and web addresses, and other potentially harmful information.
  • We will not notify you if your comment has been published. We suggest that you check back on the topic article regularly.
  • We do not provide medical or healthcare advice, treatment, or diagnosis.

Thank you for participating!


I have read and agree to abide by the MedicineNet Terms and Conditions and the MedicineNet Privacy Policy (required).

To prevent our systems from spam, please complete the following prior to submitting your comment.

Please select the white circle:

How is ascites diagnosed?

The diagnosis of ascites is based on physical examination in conjunction with a detailed medical history to ascertain the possible underlying causes since ascites is often considered a nonspecific symptom for other diseases. If ascites fluid is greater than 500ml, it can be demonstrated on physical examination by bulging flanks and fluid waves performed by the doctor examining the abdomen. Smaller amounts of fluid may be detected by an ultrasound of the abdomen. Occasionally, ascites is found incidentally by an ultrasound or a CT scan done for evaluating other conditions.

Diagnosis of underlying condition causing ascites is the most important part of understanding the reason for a person to develop ascites. The medical history may provide clues to the underlying cause and typically includes questions about previous diagnosis of liver disease, viral hepatitis infection and its risk factors, alcohol abuse, family history of liver disease, heart failure, cancer history, and medication history.

Blood work can play an essential role in evaluating the cause of ascites. A complete metabolic panel can detect patterns of liver injury, functional status of the liver and kidney, and electrolyte levels. A complete blood count is also useful by providing clues to underlying conditions. Coagulation (clotting) panel abnormalities (prothrombin time) may be abnormal because of liver dysfunction and inadequate production of clotting proteins.

Sometimes the possible underlying causes of ascites may not be determined based on the history, examination, and review of laboratory data and imaging studies. Analysis of the fluid may be necessary in order to obtain further diagnostic data. This procedure is called paracentesis, and it is performed by trained physicians. It involves sterilizing an area on the abdomen and, with the guidance of ultrasound, inserting a needle into the abdominal cavity and withdrawing fluid for further analysis.

For diagnostic purposes, a small amount (20cc, for example) may be enough for adequate testing. Larger amounts can be withdrawn if needed to reveal symptoms associated with increased abdominal ascites, up to a few liters (large volume paracentesis).

The analysis is done by sending the collected fluid to the laboratory promptly after drainage. Typically, the number and components of white blood cells and red blood cells (cell count), albumin level, gram stain and culture for any possible organisms, amylase level, glucose, total protein, and cytology (malignant or cancerous cells) are analyzed in the laboratory. The results are then analyzed by the treating doctor for further evaluation and determination of the possible cause of ascites.

Return to Ascites

STAY INFORMED

Get the latest health and medical information delivered direct to your inbox!