P3120 - Ascites Diagnosis Dilemma

Melvina C. Nnam, DO, MPH¹, Kuangdas Kenneth. Shan, MD^2
1Charles Drew University, Fontana, CA; ²University of California Irvine Digestive Health Institute, Orange, CA

Introduction: Ascites is a common finding in patients with cirrhosis; however, its presence can also be indicative of other underlying conditions. Cirrhosis is the most common cause of ascites in the Western world. It can also be due to various other etiologies, including heart failure, malignancy, and renal dysfunction.

Case Description/Methods: We report a case of a 75-year-old with a history of coronary artery disease (CAD), heart failure with reduced ejection fraction (HFrEF), alcohol use disorder, and renal impairment who presented with new-onset ascites. Initial diagnostic workup was remarkable for (SAAG 0.6g/dl). Abdominal Imaging including ultrasound and CT showed cirrhotic hepatic morphology with moderate abdominal ascites. However, further investigations including Echocardiogram revealed ascites secondary to heart failure.

Discussion: For our patient, initial diagnostic workup was equivocal; however, further investigations revealed cardiac ascites secondary to heart failure. High gradient ascites (SAAG >1.1g/dl) is a common finding in heart failure, but rare cases of low gradient ascites have been reported. This is a rare case of low gradient ascites with (SAAG >1.1) and underscores the importance of considering alternative etiologies of ascites in patients with known cardiovascular disease.



Disclosures:


Melvina C. Nnam, DO, MPH¹, Kuangdas Kenneth. Shan, MD². P3120 - Ascites Diagnosis Dilemma, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.