Ascites

Ascites is the accumulation of free fluid in the abdominal cavity.

Ascites occurs more often in long-term (chronic) than in short-term (acute) conditions. It most often occurs in cirrhosis, especially if caused by alcoholism. Ascites can also occur in conditions that do not affect the liver such as cancer, heart failure, kidney failure and tuberculosis.

In patients with liver disease, fluid leaks from the surface of the liver and intestines. Responsible is a combination of factors including the portal hypertension, decreased ability of blood vessels to retain fluid, fluid retention in the kidneys and changes of various chemical substances and hormones that control body fluids.

Causes of ascites

Liver Disease

• cirrhosis, especially cirrhosis caused by alcohol

• Alcoholic hepatitis without cirrhosis

• Chronic hepatitis

• Blockage of hepatic vein

Extrahepatic

• Heart failure

• Kidney failure, nephrotic syndrome, especially

• constrictive pericarditis

• carcinomatosis in which the cancer has spread to places in the abdominal cavity

• Tuberculosis, which affects the abdominal membrane

• Reduced active thyroid

• Inflammation of the pancreas

Symptoms and diagnosis

Small amounts of fluid in the abdomen do not usually make the symptoms, but large quantities causing abdominal distension and discomfort and dyspnea. When the doctor perkutira (bitch) the abdomen, the fluid creates a dull sound. When the stomach contains large amounts of fluid, the abdomen is tense, and the belly button (umbilicus) straight or even convex. In some people with the excessive ascites fluid swollen ankles (edema).

If the existence or cause of ascites is not clear, it can be used with. Alternatively one can take a small sample of fluid penetration of the needle through the abdominal wall, a diagnostic procedure called paracentesis. In identifying the causes can help laboratory fluids.

Treatment

Thorough treatment of ascites is bed rest in bed and no salt diet, usually combined with drugs called diuretics, which cause more fluid excretion in the urine. If ascites is causing difficulty in breathing or eating the food, fluid can be removed with a needle, a procedure called therapeutic paracentesis.

If the person does not take diuretics, the fluid tends to accumulate in the stomach again. Often the blood into the abdominal cavity are losing large amounts of albumin (the most frequent protein in the blood), and albumin may be given intravenously.

For unclear reasons, sometimes infected ascites fluid, especially in people with alcoholic cirrhosis. This infection is called spontaneous bacterial peritonitis treated with antibiotics. 

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