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What the answer to: Results of serum ascitic albumin gradient (SAAG) < 1.1 g/dL of peritoneal fluid is consistent with: a-Cirrhosis b-Alcoholic hepatitis c-Pancreatitis d-Congestive heart failure

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The answer is b-Alcoholic hepatitis. The serum ascitic albumin gradient (SAAG) is a calculation that helps to differentiate the cause of ascites, which is the accumulation of fluid in the peritoneal cavity. The SAAG is calculated by subtracting the albumin level in the ascitic fluid from the albumin level in the serum. A SAAG value of < 1.1 g/dL suggests a non-portal hypertensive cause of ascites. In the case of alcoholic hepatitis, the SAAG is typically low because the underlying cause of ascites is not related to portal hypertension. Alcoholic hepatitis is a condition that results from excessive alcohol consumption and can cause inflammation and damage to the liver. This can lead to the accumulation of fluid in the peritoneal cavity, which is known as ascites. Other causes of a low SAAG include pancreatitis and malignancy. However, these conditions are less likely to cause ascites in comparison to alcoholic hepatitis. In contrast, a high SAAG (≥ 1.1 g/dL) is typically seen in cirrhosis and congestive heart failure. In cirrhosis, the liver becomes scarred and results in portal hypertension, which leads to the accumulation of fluid in the peritoneal cavity. In congestive heart failure, the heart is unable to pump blood effectively, leading to fluid accumulation in the body including the peritoneal cavity. In summary, a SAAG value of < 1.1 g/dL is consistent with a non-portal hypertensive cause of ascites, with alcoholic hepatitis being a common cause. However, further diagnostic tests are usually required to confirm the underlying cause of ascites. Reference: Runyon BA. Care of patients with ascites. N Engl J Med. 1994;330(5):337-342. doi:10.1056/NEJM199402033300507.

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