Suggested diagnostic approach to a patient with exudative ascites. Low ascitic fluid protein should direct practitioners to rule out nephrotic
syndrome as a cause for exudative ascites. *Consideration of lymphangioscintigraphy can be done at this point to rule out lymphatic obstruction
before invasive procedure. Note: CT = computed tomography.
Although nonhepatic causes account for only about 15% of all
patients with ascites, the differential diagnosis is quite broad and
includes neoplasms of the peritoneum, lymphatic obstruction,
nephrotic syndrome and pancreatitis.
should also include mycobacterial infections, particularly in
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