Calculate your Serum-Ascites Albumin Gradient:
If greater that 11 g/L: This is considered a transudate and is likely related to portal hypertension. Think about cirrhosis, CHF (right sided), constrictive pericarditis, or Budd-Chiari syndrome.
If less than 11 g/L: This is considered an exudate and is not related to portal hypertension. Think about pancreatitis, peritoneal carcinomatosis, peritoneal TB, serositis, or low albumin states like nephrotic syndrome.
(Physical exam manoeuvres for ascites, from the JAMA rational clinical exam. Link provided below).
- JAMA's, Does This Patient Have Ascites?
- Here is a great article on managing cirrhosis and ascites from NEJM.