Ascites

ASCITES


ASCITES

  • Ascites means accumulation of free fluid in the peritoneal cavity.

 Etiology-

  • Most common cause is portal hypertension secondary to cirrhosis.
  • Tuberculous peritonitis (common cause of non- portal hypertension ascites)

Clinical features-

  • Atleast 1-2 L of fluid accumulation required to cause ascites.
  • Abdominal distension, fullness in the flanks, dullness on percussion & fluid thrill.
  • Elevated umbilicus, scrotal oedema and dilated abdominal veins.
  • Massive ascites associated with hepatic hydrothorax.

Investigations-

  • USS is the best investigations of detecting ascites.
  • SAAG= serum albumin- ascites
  • WBC increased

Treatment-

  • Salt restriction- mild ascites
  • Moderate ascites- spironolactone (diuretics), furosemide
  • First line treatment of refractory ascites- large volume paracenetesis + Albumin
  • TIPSS (transjugular intrahepatic portosystemic stent shunt)- resistant ascites

Exam Important

Investigations-

  • USS is the best investigations of detecting ascites.
  • SAAG= serum albumin- ascites
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