Ascites and its complications
Summary
Ascites is the accumulation of fluid in the peritoneal cavity. The most common causes of ascites are cirrhosis, peritoneal malignancy, and heart failure. In patients with cirrhosis, ascites is one of the complications that mark the transition from a compensated to a decompensated stage. In a patient with suspected ascites, the least invasive and most cost-effective method to confirm the presence of ascites is abdominal ultrasonography. In a patient with cirrhotic ascites, management depends on the phase of ascites at which the patient with cirrhosis is situated, from the patient with uncomplicated ascites to the patient with hepatorenal syndrome. Hepatic hydrothorax should be treated in the same way as cirrhotic ascites, that is, the mainstay of therapy is sodium restriction and diuretics. Spontaneous bacterial peritonitis is the most common type of bacterial infection in hospitalized cirrhotic patients and occurs mainly in those with low ascites protein and severe liver disease.
