Diagnosis of Ascites in Infants and Children

• Conditions: Ascites

• Registration Number: NCT03341221
• Lead Sponsor: Assiut University

Brief Summary

Ascites is the pathologic accumulation of fluid within the peritoneal cavity. Causes of ascites in infants and children :hepatobiliary disorders,serositis, neoplasm, cardiac, genitourinary disorder, metabolic disease and others.

Diagnosis of ascites :history of abdominal distention, increasing weight, respiratory embarrassement, symptoms and signs of (hepatic ,cardiac,renal disease, tuberculosis and malignancy).

lnvestigation:complete blood count, complete urine examination, liver function tests, plasma proteins, renal function tests, clotting screen, tuberculin test, chest and abdominal plain films,abdominal ultrasound, upper gastrointestinal endoscopy, abdominal paracentesis for ascitic fluid analysis .

Detailed Description

Definition : Ascites is the pathologic fluid accumulation within the peritoneal cavity .

causes of ascites in infants and children :

* Hepatobiliary disorders (cirrhosis, congenital hepatic fibrosis, acute hepatitis B,C ,Budd -chiari syndrome, Bile duct perforation)

* Serositis (crohn's disease, eosinophilic enteropathy , Henoch- Shonlein purpura )

* Neoplasm (lymphoma, wilm's tumor ,Glioma, Germ cell tumor, Ovarian tumor,mesothelioma, Neroblastoma )

* Cardiac (Heart failure )

* Metabolic disease

* Gastrointestinal disorder (Nephrotic syndrome, peritoneal dialysis ). Diagnosis of ascites :History of abdominal distention, increasing weight, respiratory embarrassement, jaundice, bleeding (haematemsis, melena, and epistaxis ),Pruritus ,Growth failure ,abdominal pain, fever,Cyanosis, ,dyspnea during suckling, Orthopnea, Buffy eyes, lower limb swelling, Haematrruria .

By examination : Tachycardia ,Tachypnea ,Hypertension ,cyanosis, jaundice, clubbing of fingers ,limb edema ,Hepatomegaly, splenomegaly, dilated abdominal wall veins.

Investigations :

Laboratory tests :complete blood count , complete urine examination, liver function tests, plasma proteins, renal function tests, clotting screen, tuberculin test.

Imaging studies :chest and abdominal plain films, abdominal ultrasound, upper gastrointestinal endoscopy CT, MR I, Abdominal paracentesis for ascitic fluid analysis :cell count / cytology ,Gram 'stain and culture, Total proteins (albumin /globulin ratio ), Glucose, Amylase, lactase dehydrogenase, Triglycerides,Bilirubin.

Serum ascites albumin gradient (SAAG )is the best single test for classification of ascites into portal hypertensive (SAAG \>1.1g/dl) and non-portal hypertensive (SAAG \<1.1g/dl) causes.

Study Timeline

• Status Verified: 2017-10
• Study First Submitted: 2017-10-28
• Study First Submitted QC: 2017-11-10
• Last Update Submitted: 2017-11-10
• Study First Posted: 2017-11-14
• Last Update Posted: 2017-11-14
• Study Start: 2017-12-01
• Primary Completion: 2018-11-01
• Study Completion: 2018-11-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• age from 1month to 18 year
• infants and children with ascites (hepatic, cardiac, renal, malignant or tuberculous )
• infants and children with peritonitis

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Exclusion Criteria

• age <1month
• surgical conditions as ruptured viscous or located abscess

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Diagnosis of ascites in infants and children with hepatic, cardiac, renal disease, tuberculosis and malignancy	1 year	Diagnosis of ascites in infants and children fromega age of 1month to 18 year