Ultrasonic differentiation of types of ascitic fluid

A review of 65 cases of proven ascites was done to assess the accuracy of ultrasound in distinguishing transudates from exudates. In 10 patients with malignant ascites, ultrasound suggested this in six by showing matted bowel loops, loculation, or hepatic metastasis. In each of the five patients with peritonitis, infected ascites was suggested by observing septations or debris within the fluid. A sonographic diagnosis of exudate was not made in any of the 50 confirmed transudates. The echographic characteristics which may suggest infected or malignant ascites are discussed.