Ascites: diagnosis and management.
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 eg, spontaneous bacterial peritonitis. Although sodium restriction and diuretics remain 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. This review article summarizes diagnostic tools and provides an evidence-based approach to the management of ascites.
Hou
Wei
W
Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, MCV Box 980341, Richmond, VA 23298-0341, USA.
Sanyal
Arun J
AJ
D001201:Ascites / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001202:Ascitic Fluid / Q000737:chemistry; D002302:Cardiac Output; D004039:Diet, Sodium-Restricted; D018450:Disease Progression; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005665:Furosemide / Q000008:administration & dosage; D006801:Humans; D006975:Hypertension, Portal / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology; D019152:Paracentesis; D010536:Peritoneovenous Shunt; D010538:Peritonitis; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011379:Prognosis; D013148:Spironolactone / Q000008:administration & dosage; D013152:Splanchnic Circulation / Q000502:physiology; D014664:Vasodilation
D004232:Diuretics; D013148:Spironolactone; D005665:Furosemide