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Table 24.2

Causes of Ascites According to the Serum-to-Ascites Albumin Gradient (SAAG)

High SAAG ( 11 g/L.) (associated with portal hypertension)
  • Cirrhosis
  • Alcoholic hepatitis
  • Hepatic outflow obstruction:
    • Budd-Chiari syndrome (thrombosis of one or more of the large hepatic veins, the inferior vena cava, or both)
    • Hepatic veno-occlusive disease
  • Cardiac ascites:
    • Severe tricuspid regurgitation
    • All causes of right-sided heart failure
    • Constrictive pericarditis

Low SAAG (<11 g/L) (associated with peritoneal neoplasms, infection and inflammation)

  • Peritoneal carcinomatosis
  • Peritoneal tuberculosis
  • Pancreatitis
  • Serositis
  • Nephrotic syndrome
  • Chylous ascites (lymphatic vessel rupture)
  • Myxedema
  • Meig's syndrome