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February 23, 1963

Mimetic Aspects of Ascites

Author Affiliations


From the Hektoen Institute for Medical Research, and the Department of Internal Medicine—Gastroenterology Section of Cook County Hospital, and the departments of internal medicine, Northwestern University Medical School and University of Illinois College of Medicine.

JAMA. 1963;183(8):651-655. doi:10.1001/jama.1963.03700080059016

This paper is a report of 100 patients with ascites undiagnosed by the usual diagnostic procedures but definitively diagnosed by peritoneoscopy. The causes of ascites in these patients were, in order of frequency, cirrhosis (34), metastatic malignancy (24), tuberculous peritonitis (23), hepatoma (13), pancreatitis (4), myxedema (1), and constrictive pericarditis (1). Helpful clinical hints are provided for the differential diagnosis of these conditions. The best laboratory test in the diagnosis of ascites is the study of the ascitic fluid. Cirrhosis and constrictive pericarditis had fluids containing less than 3.0 gm of protein per 100 ml, indicating a transudate. Carcinomatosis, hepatoma, tuberculous peritonitis, and pancreatitis had fluids containing more than 3.0 gm of protein per 100 ml, indicating an exudate. A scheme is presented which should help in the differential diagnosis of most cases of ascites.