Ascites

Ascites is a collection of fluid in abdominal cavity

Common causes of Ascites are

  • Liver failure
  • Tuberculosis
  • Peritoneal malignancy
  • Heart failure
  • Nephrotic syndrome
  • Systemic Lupus Erythematosus

Diagnosis

  • Confirmed by Ultrasonography.
  • Underlying etiology is diagnosed by various tests such as
    • CECT abdomen
    • Peritoneal biopsy
    • Laparoscopy
    • Ascites fluid evaluation
    • ADA
    • TLC/DLC
    • CytologyProtein/albumin
    • AFB and TB culture

Management

Management depends upon the underlying cause.

  • Ascites in a patient with chronic liver disease is an indicator of advanced diseases, these patients are treated with diuretics and salt restriction, and many of these patients are candidate for liver transplantation.
  • Infection of Ascites in liver disease patients is defined as Spontaneous Bacterial Peritonitis (SBP), and is treated by IV antibiotics, albumin followed by oral antibiotics. Patients with SBP are the candidates for liver transplantation.
  • Tubercular Ascites is treated by ATT
  • Malignant Ascites requires chemotherapy

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