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Ascitic Fluid

Ascitic Fluid Cell Count

February 15th, 2021


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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