Ultrasound and Ascites

NCT ID: NCT07196553

Last Updated: 2025-09-29

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 125 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-10-01
• Study Completion Date: 2027-10-01

Brief Summary

The aim of this study is to evaluate the role of ultrasound in the detection, characterization, and determination of the underlying cause of ascites in patients attending Assiut University Hospital

Detailed Description

Normally, the peritoneal cavity contains 25-50 mL of ascitic fluid, which allows for the movement of bowel loops past one other and helps hydrate serosal surfaces. Ascites is defined as the pathological accumulation of excess fluid in the peritoneal cavity.

More than one cause may be responsible for the development of ascites (multifactorial), liver cirrhosis remains the leading cause (≈85% of cases), followed by many causes such as malignant neoplasia, tuberculous infection, cardiac insufficiency, renal diseases ,trauma and other infectious, inflammatory and hemorrhagic causes ,multiple etiologies may coexist.

once ascites develops, it carries a risk of further serious complications such as acute spontaneous bacterial peritonitis (SBP) (Occurs in 10-30% of hospitalized cirrhotic patients with ascites and associated with high morbidity and mortality rate), hepatorenal syndrome, hepatic hydrothorax, respiratory compromise and other compliactions including gastrointestinal, circulatory , metabolic complications….etc Medical history, physical examination, abdominal ultrasound, blood tests, and a diagnostic paracentesis for ascitic fluid analysis should all be part of the initial assessment of ascites. Ascites can be detected on physical examination using traditional shifting dullness to percussion when there is approximately 500 ml of fluid. However, in an increasingly obese population, there is limited reliability on clinical examination findings alone.

Trans-abdominal US (TAUS) can easily demonstrate large volumes of fluid and, with a meticulous technique, much smaller volumes can also be detected making an excellent first-line imaging tool, safe, inexpensive, and widely available, It's also superior to CT in qualitative assessment-distinguishing between simple (anechoic) and complex (particulate or septated) ascites.Portable ultrasound devices further enable reliable, bedside diagnosis.

Ultrasound is also used in ultrasound-guided aspiration and paracentesis which is essential for safely obtaining ascitic fluid for determining the underlying etiology (via Serum-Ascites Albumin Gradient (SAAG), cytology, biochemical analysis) and detecting complications such as spontaneous bacterial peritonitis,The presence of septations or debris in ascites fluid can be suggestive of infected ascites.

The most important diagnostic study of any patient being evaluated for SBP or being admitted to the hospital with ascites and cirrhosis is a paracentesis. In a US national inpatient study of over 31,000 patients admitted with cirrhosis and ascites where about one-half underwent a paracentesis, the mortality rate for patients who underwent a paracentesis was significantly lower than for those who did not have one (6.3% vs 8.9%). hemorrhagic ascites, or malignant recurrence.

Real-time ultrasound improves diagnostic accuracy and reduces complication rates compared with landmark-based aspiration..Using ultrasound guidance for paracentesis significantly reduces complication rates, such as bleeding and infection.complication rates drop from ~4.7% (landmark-based) to ~1.4% with ultrasound.

therapeutic paracentesis is established as the first-line treatment for patients with large or refractory ascites providing rapid symptom relief and improving quality of life. It is safe when done under ultrasound guidance with albumin replacement for large-volume drainage.

' We chose to carry out this study to evaluate the specificity, sensitivity, accuracy, and positive and negative predictive value of role of ultrasound in detection of ascites and evaluation of the underlying cause.

Conditions

Ultrasound in Ascites

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Interventions

Ultrasound

ultrasound examination

Intervention Type: DEVICE

Eligibility Criteria

Inclusion Criteria

• Patient from different age groups and both sexex will be included in our study.
• Patients with clinically suspected ascites referred for abdominal ultrasound.
• Patients who will provide informed consent for participation.

Exclusion Criteria

• Patients with a history of recent abdominal surgery (<1 month).
• Patients with inadequate ultrasound visualization due to severe obesity or extensive bowel gas.
• Patients who will decline to participate

• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Assiut University

OTHER

Sponsor Role: lead

Responsible Party

Esraa Mohamed Sayed Abdelaziz

Dr

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Sami Abdel-Aziz Khalil, proffesor

Role: STUDY_DIRECTOR

Assiut University

Central Contacts

Esraa Mohamed Abdelaziz

Role: CONTACT

es2011es99@gmail.com

+201015039486

Hayam Yahia Khalil, lecturer

Role: CONTACT

Hayamyahia1989@gmail.com

+201067949776

Other Identifiers

Role of ultrasound in ascites

Identifier Type: -

Identifier Source: org_study_id