ROLE OF COMPUTED TOMOGRAPHY IN EVALUATION OF ASCITES

Ascites result from variety of medical & surgical causes, and ultrasonography (US) or computed tomography (CT) of abdomen is advisable for its detection, and the different CT signs depend on amount and distribution of fluid. OBJECTIVES: To evaluate ascitic fluid collections, their etiologies in relation to CT scan findings, evaluating the role of CT scan to differentiate ascites from other space-occupying masses and to evaluate the role of CT scan in determining the etiology of ascites of unknown origin. MATERIAL AND METHODS: Hundred patients with an age range of 18-88 years had ascites, been referred for CT scan of abdomen as a further diagnostic step to confirm & identify the possible underlying cause of ascites. Abdominal CT scan had been done using 6mm slice thickness (oral diluted gastrografin 1.5-2hrs prior to examination) & two sets of CT examinations had been done with 350mg/ml IV omnipaque (in indicated patients only) or without contrast. Results: 100 patients with ascites underwent CT scan. The study showed that CT was very sensitive in detection of ascites, with sensitivity of 100% and the different signs of ascites on CT images depended on the amount of ascetic fluid producing either (early) or (late) signs. The frequency of the underlying causes of ascites was-54% cases of neoplasm, 17% liver cirrhosis, 14% acute pancreatitis, 6% abdominal tuberculosis, 5% intestinal obstruction and 4% chronic renal failure. DISCUSSION: Associated organ involvement was seen in 98 cases (98%). Isolated Ascites was seen in 2 cases (2%). CONCLUSION: CT was very sensitive in detection of ascites, and most useful in identifying the underlying cause of it, but still some of the patients require further investigative steps.