|Introduction to Ascites
In medicine (gastroenterology), Ascites (also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more archaically as abdominal dropsy) is an accumulation of fluid in the Although most commonly due to cirrhosis and severe liver disease, its presence can portend other significant medical problems. Diagnosis of the cause is usually with blood tests, an ultrasound scan of the abdomen and direct removal of the fluid by needle or paracentesis (which may also be therapeutic). Treatment may be with medication (diuretics), paracentesis or other treatments directed at the cause.
Signs and Symptoms of Ascites
Mild ascites is hard to notice, but severe ascites leads to abdominal distension. Patients with ascites generally will complain of progressive abdominal heaviness and pressure as well as shortness of breath due to mechanical impingement on the diaphragm.
Ascites is detected on physical examination of the abdomen by visible bulging of the flanks in the reclining patient ("flank bulging"), "shifting dullness" (difference in percussion note in the flanks that shifts when the patient is turned on the side) or in massive ascites with a "fluid thrill" or "fluid wave" (tapping or pushing on one side will generate a wave-like effect through the fluid that can be felt in the opposite side of the abdomen).
Other signs of ascites may be present due to its underlying etiology. For instance, in portal hypertension (perhaps due to cirrhosis or fibrosis of the liver) patients may also complain of leg swelling, bruising, gynecomastia, hematemesis, or mental changes due to encephalopathy. Those with ascites due to cancer (peritoneal carcinomatosis) may complain of chronic fatigue or weight loss. Those with ascites due to heart failure may also complain of shortness of breath as well as wheezing and exercise intolerance.
Causes of Ascites
Causes of high SAAG ("transudate") are:
* Cirrhosis - 81% (alcoholic in 65%, viral in 10%, cryptogenic in 6%)
* Heart failure - 3%
* Hepatic Venous occlusion: Budd-Chiari syndrome or veno-occlusive disease
* Constrictive pericarditis
Causes of low SAAG ("exudate") are:
* Cancer (primary peritoneal carcinomatosis and metastasis) - 10%
* Infection: Tuberculosis - 2% or Spontaneous bacterial peritonitis
* Pancreatitis - 1%
* Nephrotic syndrome or Protein losing enteropathy
* Hereditary angioedema.
Other Rare causes:
* Meigs syndrome
* Renal Dialysis
Ascites is generally treated simultaneously while an underlying etiology is sought in order to prevent complications, to relieve symptoms and to prevent further progression. In patients with mild ascites, therapy is usually as an outpatient. The goal is weight loss of no more than 1.0 kg/day for patients with both ascites and peripheral edema and no more than 0.5 kg/day for patients with ascites alone. In those with severe ascites causing a tense abdomen, hospitalization is generally necessary for paracentesis.
SAVLIV DROPS is highly effective in providing relief from Ascites
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