Overview
The ascitic fluid cell count provides a measure of the number of red blood cells, white blood cells and white cell differential; this information can be used to guide the differential diagnosis of a patient with ascites.
Red Blood Cells
Red blood cells within ascitic fluid may simply be due to a traumatic tap or inadvertent sampling from an abdominal vessel; blood may also be present within ascites in the presence of an intra-abdominal bleed as well as certain other conditions.
Causes of RBC in Ascitic Fluid
- Traumatic collection
- Neoplasm
- Pancreatitis
- Tuberculous peritonitis
- Intra-abdominal bleedAssociated with massive numbers of RBC
White Blood Cells
White blood cells within ascitic fluid suggest infection or malignancy.
Normal Range
- <250 polymorphonuclear cells/μL
Interpretation
- Polymorphonuclear predominance (>500PMNs/μL) - suggestive of spontaneous bacterial peritonitis
- Lymphocytic predominance - present in tuberculous peritonitis
Causes of WBC in Ascitic Fluid
- Cirrhosis
- Bacterial peritonitis
- Tuberculous peritonitis
- Neoplasm
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