This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
Ascitic fluid analysis findings suggestive of gut perforation is: 
Select and explain. 
A. LDH > 600 and Sugar < 50, B. Total count > 15,000, C. ALP > 240 and CEA > 5, D. E.coli positive ascitic fluid culture
C: ALP > 240 and CEA > 5
Answer: C: ALP > 240 and CEA > 5 
Explanation: An ascitic ?uid carcinoembryonic antigen > 5 ng/mL or ascitic ?uid alkaline phosphatase > 240 U/L is found to be accurate in detecting gut perforation into ascitic ?uid. E.Coli positive culture-(single organism) is suggestive of primary bacterial peritonitis with intact gut. High LDH and low sugar may be seen with gut perfoaion butt can also seen in other conditions as well. Ref: HEPATOLOGY, June 2009