[Ascites].
Ascites means accumulation of fluid within the peritoneal cavity, usually in patients with cirrhosis. Diagnostic paracentesis (cell count, albumin, cell culture) is a must. Na-restriction remains the cornerstone of treatment (< 3 g NaCl/d). Spironolactone is the drug of choice, in some patients in addition with proximally acting diuretics. Minimum effective dosage is recommented to reduce side-effects. Pronounced ascites can be treated by large-volume paracentesis with concomitant albumin-infusion. Only very few patients suffer from refractory ascites. TIPS is a treatment modality for this group. However, TIPS may precipitate PSE in some patients with decompensated liver cirrhosis.
Maier
K P
KP
Leberzentrum, Klinikum Esslingen, Akademisches Lehrkrankenhaus der Universität Tübingen. kp.maier@kliniken-es.de
D000465:Algorithms; D001201:Ascites / Q000209:etiology* / Q000628:therapy; D003937:Diagnosis, Differential; D004039:Diet, Sodium-Restricted; D006530:Hepatorenal Syndrome / Q000175:diagnosis; D006801:Humans; D019152:Paracentesis; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D013148:Spironolactone / Q000627:therapeutic use
D013148:Spironolactone