Pseudoascites in the clinical setting: avoiding unwarranted and futile paracenteses.
Ascites is diagnosed on physical exam by findings of abdominal distension, bulging flanks, shifting dullness and a prominent fluid wave. However, as the following cases demonstrate, these signs may also be positive in pseudoascites due to thick layers of adipose tissue in the abdomen. A history of recent food binging and a lack of a prolonged prothrombin time should raise the index of suspicion for pseudoascites in a patient with a protuberant abdomen. In light of equivocal physical signs, physicians may employ ultrasonography to prevent patients with pseudoascites from suffering multiple futile attempts at paracentesis.
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Division of General Internal Medicine, Medical College of Wisconsin, Froedert Memorial Lutheran Hospital, Milwaukee 53226-3522, USA.
Schiedermayer
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D000328:Adult; D001201:Ascites / Q000175:diagnosis*; D001068:Feeding and Eating Disorders / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011517:Prothrombin Time; D015430:Weight Gain