saag - romba

[ArchivalUser]

Is Subacute baeterial peritonitis `s SAAG greater than 1.1?


But if it is infection then SAAG should be lower than 1.1?
I am confused and not clear with this concept can anyone explain to me?

thanks

[ArchivalUser]

OK....

- Basically SAAG is used to differentiate between Portal v/s Non-Portal Hypertensive Ascities.

- SAAG reflects the pressure in the hepatic sinusoids & correlates with the hepatic venous pressure gradient.

- SAAG more than 1.1g/dl means presence of portal HT and so ascities is from an increased pressure in the hepatic sinusoids. Causes are: cirrhosis, cardiac ascites, sinusoidal obstruction syndrome (venoocclusive disease), massive liver metastasis, or hepatic vein thrombosis (Budd-Chiari syndrome).

- Now with high SAAG that is more than 1.1, we can diagnose more diseases based on the ascitic protein level. If the Ascitic protein level is more than 2.5g/dl, then it means the hepatic sinusoids are normal and causes are cardiac ascites ( CHF, Constrictive Pericarditi), sinusoidal obstruction syndrome, or early Budd-Chiari syndrome & IVC obstruction.
If Ascitic protein is less than 2.5g/dl, then it means that the he hepatic sinusoids have been damaged and no longer allow passage of protein, causes are: cirrhosis, late Budd-Chiari syndrome, or massive liver metastases.

- If SAAg is less than 1.1g/dl, then the causes are Biliary leak, Nephrotic Syndrome, Pancreatitis, TB etc.

[ArchivalUser]

SBP.....SAAG is less than 1.1

[ArchivalUser]

THank you so much for explanation Dr. Chapper.
I thought portal HT and cirrhosis SAAG is greater than 1.1 and
SBP is caused under cirrhosis condition?
Isn`t it?
If I am wrong, please correct me.
THanks.

[ArchivalUser]

if u r lookin for Spontaneous Bact Peritonitis...the SAAg is more than 1.1

If u r looking for Secondary Bact Peritonitis, then SAAG is less than 1.1..

[ArchivalUser]

Thank you so much. Sorry for confusion. I meant Spontaneous bac peritonitis.
I should have written full name.
So, spontaneous bac peritonitis occurs under cirrhosis condition , right?

final confirmation.

[ArchivalUser]

Yes....

Spontaneous Bacterila Peritonitis occur almost exclusively in the setting of a severe liver disease. This can be Chronic Cirhossis of the liver of Acute Fulminant Hepatic Failure or even Subacute Alcoholic Hepatitis...Cirhosis can be complicated by Spontaneous Bacterial Peritonitis...

There is also Noncirrhotic spontaneous bacterial peritonitis but it is very rare...