Ascites is the presence of excess fluid in the peritoneal cavity. Ascites is more often associated with liver disease and other long-lasting (chronic) conditions. Ascites is excess fluid in the space between the tissues lining the abdomen and abdominal organs (the peritoneal cavity). Ascites occur in long-standing disorders including cirrhosis, alcoholic hepatitis without cirrhosis, chronic hepatitis, and obstruction of the hepatic vein. Several blood tests are commonly performed for ascites, including full blood count, electrolytes and renal function, liver enzymes, and glucose. If the cause is not apparent, serology for viruses known to cause hepatitis and ferritin may contribute to the analysis.
Ascites is the pathologic accumulation of fluid in the peritoneal cavity and is a common manifestation of liver failure, being one of the cardinal signs of portal hypertension. The diagnostic evaluation of ascites involves an assessment of its cause by determining the serum-ascites albumin gradient and the exclusion of complications e.g., spontaneous bacterial peritonitis. Although sodium restriction and diuretics remains the cornerstone of ascites management, many patients require additional therapy when they become refractory to such medical treatment. These include repeated large volume paracentesis and transjugular intrahepatic portosystemic shunts.
Small amounts of ascitic fluid cause no symptoms. Moderate amounts cause increased abdominal girth and weight gain. Massive amounts may cause nonspecific diffuse abdominal pressure, but actual pain is uncommon. If ascites results in elevation of the diaphragm, dyspnea may occur. Symptoms of SBP may include new abdominal discomfort and fever.
Professor EBM is a fantastic tool for focused, point-of-care teaching for attending rounds.
Ascites is the pathologic accumulation of fluid in the peritoneal cavity and is a common manifestation of liver failure, being one of the cardinal signs of portal hypertension. The diagnostic evaluation of ascites involves an assessment of its cause by determining the serum-ascites albumin gradient and the exclusion of complications e.g., spontaneous bacterial peritonitis. Although sodium restriction and diuretics remains the cornerstone of ascites management, many patients require additional therapy when they become refractory to such medical treatment. These include repeated large volume paracentesis and transjugular intrahepatic portosystemic shunts.
Small amounts of ascitic fluid cause no symptoms. Moderate amounts cause increased abdominal girth and weight gain. Massive amounts may cause nonspecific diffuse abdominal pressure, but actual pain is uncommon. If ascites results in elevation of the diaphragm, dyspnea may occur. Symptoms of SBP may include new abdominal discomfort and fever.
Professor EBM is a fantastic tool for focused, point-of-care teaching for attending rounds.
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