Ascitic fluid analysis

Parameter Key Findings Common Causes
Appearance Clear/Straw-Coloured Cirrhosis
 Cloudy/Turbid Spontaneous bacterial peritonitis (SBP)
 Milky (Chylous) Lymphatic obstruction (e.g., lymphoma, malignancy, Tuberculosis
 Bloody Traumatic tap, malignancy, ruptured vessel
SAAG (>1.1 g/dL) Portal hypertension Cirrhosis, Budd-Chiari syndrome
SAAG (<1.1 g/dL) No portal hypertension Peritoneal carcinomas, TB, pancreatic ascites
Total Protein (>4 g/dL) High protein TB, SBP
Glucose (<50 mg/dL) Low glucose TB, malignancy
Amylase Elevated amylase Pancreatic ascites
WCC (>250/dL) High WCC SBP (predominantly neutrophils), 
TB (predominantly lymphocytes)
Culture Positive SBP, secondary peritonitis

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