title: Cirrhotic ascites review: Pathophysiology, diagnosis and management.
abstract: Ascites is a pathologic accumulation of peritoneal fluidcommonly observed in decompensated cirrhotic states.Its causes are multi-factorial, but principally involve significant volume and hormonal dysregulation in the setting of portal hypertension. The diagnosis of ascites is considered in cirrhotic patients given a constellation of clinical and laboratory findings, and ultimately confirmed, with insight into etiology, by imaging and paracentesis procedures. Treatment for ascites is multi-modal including dietary sodium restriction, pharmacologic therapies, diagnostic and therapeutic paracentesis, and in certain cases transjugular intra-hepatic portosystemic shunt. Ascites is associated with numerous complications including spontaneous bacterial peritonitis, hepato-hydrothorax and hepatorenal syndrome. Given the complex nature of ascites and associatedcomplications, it is not surprising that it heralds increased morbidity and mortality in cirrhotic patients and increased cost-utilization upon the health-care system. This review will detail the pathophysiology of cirrhotic ascites, common complications derived from it, and pertinent treatment modalities.
authors.affiliation: Christopher M Moore, David H Van Thiel, Section of Hepatology, Department of Medicine, Rush University Medical Center, Chicago, IL 60612, United States.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Moore
authors.forename: David H
authors.initials: DH
authors.lastname: Van Thiel
keywords: Ascites; Cirrhosis; Hepato-hydrothorax; Hepatorenal syndrome; Spontaneous bacterial peritonitis