Management of ascites in children.
Ascites is the pathologic accumulation of fluid within the peritoneal cavity. There are many causes of fetal, neonatal and pediatric ascites; however, chronic liver disease and subsequent cirrhosis remain the most common. The medical and surgical management of ascites in children is dependent on targeting the underlying etiology. Broad categories of management strategies include: sodium restriction, diuresis, paracentesis, intravenous albumin, prevention and treatment of infection, surgical and endovascular shunts and liver transplantation. This review updates and expands the discussion of the unique considerations regarding the management of cirrhotic and non-cirrhotic ascites in the pediatric patient.
a 1 Pediatric Gastroenterology, University of Washington School of Medicine, 4800 Sand Point Way, NE, PO Box 5371/OB.9.640, Seattle, WA 98105, USA.
Erin R
ER
Lane
b 2 Division of Gastroenterology and Hepatology Seattle Children's and the University of Washington, PO Box 5371/OB.9.640, Seattle, WA 98155, USA.
Evelyn K
EK
Hsu
b 2 Division of Gastroenterology and Hepatology Seattle Children's and the University of Washington, PO Box 5371/OB.9.640, Seattle, WA 98155, USA.
Karen F
KF
Murray
D000418:Albumins / Q000008:administration & dosage; D001201:Ascites / Q000209:etiology* / Q000628:therapy*; D001424:Bacterial Infections / Q000150:complications; D006502:Budd-Chiari Syndrome / Q000150:complications; D002648:Child; D002675:Child, Preschool; D002915:Chylous Ascites / Q000209:etiology / Q000628:therapy; D004039:Diet, Sodium-Restricted; D004232:Diuretics / Q000627:therapeutic use*; D005440:Fluid Therapy; D006333:Heart Failure / Q000150:complications; D006504:Hepatic Veno-Occlusive Disease / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007249:Inflammation / Q000150:complications; D015212:Inflammatory Bowel Diseases / Q000150:complications; D008103:Liver Cirrhosis / Q000150:complications; D009369:Neoplasms / Q000150:complications*; D009404:Nephrotic Syndrome / Q000150:complications; D010182:Pancreatic Diseases / Q000150:complications; D019152:Paracentesis; D010538:Peritonitis / Q000188:drug therapy / Q000382:microbiology; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D014570:Urologic Diseases / Q000150:complications
D000418:Albumins; D004232:Diuretics
ascites; cirrhosis; diuresis; hypoalbuminemia; paracentesis; pediatrics; renin–angiotensin–aldosterone system; transjugular intrahepatic portosystemic shunt