Ascites | |
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Other names | Peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum, abdominal dropsy[1] |
The abdomen of a person with cirrhosis that has resulted in massive ascites and prominent superficial veins | |
Pronunciation | |
Specialty | Gastroenterology |
Symptoms | Increased abdominal size, increased weight, abdominal discomfort, shortness of breath[3] |
Complications | Spontaneous bacterial peritonitis, hepatorenal syndrome, low blood sodium[3][4] |
Causes | Liver cirrhosis, cancer, heart failure, tuberculosis, pancreatitis, blockage of the hepatic vein[4] |
Diagnostic method | Physical exam, ultrasound, CT scan[3] |
Treatment | Low-salt diet, medications, draining the fluid[3] |
Medication | Spironolactone, furosemide[3] |
Frequency | >50% of people with cirrhosis[4] |
Ascites (/əˈsaɪtiz/;[5] Greek: ἀσκός, romanized: askos, meaning "bag" or "sac"[6]) is the abnormal build-up of fluid in the abdomen.[1] Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur.[4] Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath.[3] Complications can include spontaneous bacterial peritonitis.[3]
In the developed world, the most common cause is liver cirrhosis.[4] Other causes include cancer, heart failure, tuberculosis, pancreatitis, and blockage of the hepatic vein.[4] In cirrhosis, the underlying mechanism involves high blood pressure in the portal system and dysfunction of blood vessels.[4] Diagnosis is typically based on an examination together with ultrasound or a CT scan.[3] Testing the fluid can help in determining the underlying cause.[3]
Treatment often involves a low-salt diet, medication such as diuretics, and draining the fluid.[3] A transjugular intrahepatic portosystemic shunt (TIPS) may be placed but is associated with complications.[3] Attempts to treat the underlying cause, such as by a liver transplant, may be considered.[4] Of those with cirrhosis, more than half develop ascites in the ten years following diagnosis.[4] Of those in this group who develop ascites, half will die within three years.[4]