Correspondence
Fahmi Yousef Khan, (MD), Senior specialist, Department of medicine, Hamad General Hospital, P.O.Box : 3050, Doha-Qatar. E-mail: fakhanqal@yahoo.co.uk, Tel 0974- 5275989, Fax:0974-4879228.

Background: The clinical characteristics of ascites due to malignancy are not fully known, and it appears as a variable entity with different types of clinical presentation and with a difficult diagnosis.
Objectives: the aim of this study is to describe the clinical pattern of ascites due to malignancy in Qatar and to evaluate the diagnostic efficacy of serum/ascitic albumin gradient in differentiating different types of ascites caused by malignancy.
Methods: a descriptive prospective study of patients admitted to Hamad general hospital with ascites due to malignancy.
Results: The total number of patients included in this study was 22 patients. Based on serum ascitic albumen gradient, ascites due to malignancy was divided into two main groups; first, with serum/ascitic albumin gradient < 1.1 g/dL, second, serum/ascitic albumin gradient > 1.1 g/dL. The firs group was consistent with carcinomatous peritonitis (Malignant ascites), while the second group represented tumors metastasizing to the liver leading to portal hypertension (malignancy related ascites). Ovarian carcinoma was the most common primary tumour in patients with malignant ascites while gall bladder cancer was most common primary tumour in patients with malignant related ascites.
Conclusion: serum/ascitic albumin gradient is effective in differentiating between malignant and malignancy related ascites. Along with the currently available, largely unsatisfactory treatment alternatives, these data might change our present clinical management of ascites due to malignancy.

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