Abstracts Poster Abstracts - Dr Falk

19Clinical and diagnostic value of serum-ascites albumin gradientin diseases with ascitesColic N., Kazic S., Svorcan P., Necic D., Dapcevic B.Department of Gastroenterology and Hepatology, Zvezdara Clinical Center, Belgrade,Serbia and MontenegroIntroduction: The serum-ascites albumin gradient (SAAG) has been proved in multiplestudies to categorize ascites better than the total protein concentration, which classifiesascites into exudate ($ 25 g/l) and transudate (< 25 g/l). If the SAAG is greater than1.1 g/dl, the patient has portal hypertension with approximately 97% accuracy. SAAGis the difference between the serum and ascites albumin concentration. This differencecorrelates directly with portal pressure, which is based on oncotic-hydrostatic balance.Methods: SAAG was measured in 96 patients with ascites. All patients were divided intwo groups. One group included 76 patients who had ascites and portal hypertension(55 patients with decompensated liver cirrhosis, 9 with heart failure, 4 with massive livermetastases, 6 with mix ascites and 2 with peritoneal carcinomatosis). The other groupincluded 20 patients who did not have portal hypertension (13 with peritonealcarcinomatosis, 3 with peritoneal mesothelioma, 3 with pancreatic ascites and 1 withTBC peritonitis). SAAG was determined by a person who was unaware of diagnosis(blind study).Results: SAAG values were greater than 1.1 g/dl in all patients who had ascites andportal hypertension (average value: 2.3 g/dl ± 0.5 g/dl). SAAG values were less than 1.1g/dl in the patients without portal hypertension (average value: 0.9 g/dl ± 0.5 g/dl).Discussion/Conclusion: SAAG values above 1.1 g/dl point to portal hypertension asthe cause of ascites. SAAG values below 1.1 g/dl point to the other causes of ascites.SAAG has significant clinical and diagnostic value in diseases with ascites.