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Ascitic Fluid

Ascitic Fluid Cell Count



  • 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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