Cancer (metastasis and primary peritoneal carcinomatosis) – 10%.Kwashiorkor (childhood protein-energy malnutrition).Hepatic venous occlusion: Budd–Chiari syndrome or veno-occlusive disease.Cirrhosis – 81% (alcoholic in 65%, viral in 10%, cryptogenic in 6%).Causes Causes of high serum-ascites albumin gradient (SAAG or transudate) are In case of minor thrombosis, there are some chances of survival using cadaveric liver transplant. When a person with liver cirrhosis has thrombosis, it is not possible to perform a liver transplant, unless the thrombosis is very minor. This can lead to portal hypertension and a reduction in blood flow. Portal vein thrombosis and splenic vein thrombosis involve clotting of blood affects the hepatic portal vein or varices associated with splenic vein. Those with ascites due to heart failure may also complain of shortness of breath as well as wheezing and exercise intolerance.Ĭomplications may include spontaneous bacterial peritonitis, hepatorenal syndrome, and thrombosis. Those with ascites due to cancer (peritoneal carcinomatosis) may complain of chronic fatigue or weight loss. For instance, in portal hypertension (perhaps due to cirrhosis or fibrosis of the liver) people may also complain of leg swelling, bruising, gynecomastia, hematemesis, or mental changes due to encephalopathy. Other signs of ascites may be present due to its underlying cause. Īscites is detected with physical examination of the abdomen by visible bulging of the flanks in the reclining person ("flank bulging"), " shifting dullness" (difference in percussion note in the flanks that shifts when the person is turned on the side), or in massive ascites, with a "fluid thrill" or " fluid wave" (tapping or pushing on one side will generate a wave-like effect through the fluid that can be felt in the opposite side of the abdomen). People with ascites generally will complain of progressive abdominal heaviness and pressure as well as shortness of breath due to mechanical impingement on the diaphragm. Mild ascites is hard to notice, but severe ascites leads to abdominal distension. The term is from the Greek askítes meaning "baglike". Of those in this group who develop ascites, half will die within three years. Of those with cirrhosis, more than half develop ascites in the ten years following diagnosis. Attempts to treat the underlying cause, such as by a liver transplant may be considered. A transjugular intrahepatic portosystemic shunt (TIPS) may be placed but is associated with complications. Treatment often involves a low-salt diet, medication such as diuretics, and draining the fluid. Testing the fluid can help in determining the underlying cause. Diagnosis is typically based on an examination together with ultrasound or a CT scan. In cirrhosis, the underlying mechanism involves high blood pressure in the portal system and dysfunction of blood vessels. Other causes include cancer, heart failure, tuberculosis, pancreatitis, and blockage of the hepatic vein. In the developed world, the most common cause is liver cirrhosis. Complications can include spontaneous bacterial peritonitis. Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath. Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. Low-salt diet, medications, draining the fluid Īscites is the abnormal build-up of fluid in the abdomen. Liver cirrhosis, cancer, heart failure, tuberculosis, pancreatitis, blockage of the hepatic vein Spontaneous bacterial peritonitis, hepatorenal syndrome, low blood sodium Increased abdominal size, increased weight, abdominal discomfort, shortness of breath
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