Ascites

Hepaticfailure[1]

Ascites is a pathologic accumulation of fluid within the abdominal cavity. The fluid can accumulate as an exudate or a transudate.


Presentation

urogenital
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  • cardiovascular
    Heart Failure
    • For example, peritoneal carcinomatosis or malignant ascites may be treated by surgical resection of the cancer and chemotherapy , while management of ascites related to heart failure is directed toward treating heart failure with medical management and[medicinenet.com]
    • It is well documented that most cases are caused by a genetic predisposition to pulmonary hypertension, which progresses to congestive heart failure and terminal ascites in many cases.[merckvetmanual.com]
    • When clinically detectable, ascites may indicate underlying heart failure, liver disease, nephrotic syndrome, or malignancy.[jamaevidence.mhmedical.com]
    • Transudative ascites (Serum Albumin - Ascites Albumin 1.1 gm/dl) Liver cirrhosis Congestive heart failure Hepativ vein obstruction (Budd Chiari syndrome) a.[enotes.tripod.com]
    • "Heart Failure Society of America (HFSA) 2006 Comprehensive Heart Failure Practice Guideline".[en.wikipedia.org]
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  • musculoskeletal
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  • gastrointestinal
    Abdominal Pain
    • ‘Patients present with the insidious onset of ascites, abdominal pain, and fever.’[oxforddictionaries.com]
    • Abdominal pain, discomfort and difficulty breathing : These may occur when too much fluid accumulates in the abdominal cavity.[patients.gi.org]
    • The fluid causes pressure on other organs in the abdominal area and may lead to: clothes feeling tighter or needing a bigger belt size bloating abdominal pain back pain difficulty sitting comfortably and moving around loss of appetite indigestion constipation[cancerresearchuk.org]
    • Patients can complain of increasing abdominal girth, generalized abdominal pain and shortness of breath.[cancertherapyadvisor.com]
    • This causes the triad of ascites, abdominal pain , and hepatosplenomegaly (enlargement of the liver and spleen).[emedicinehealth.com]
    Vomiting
    • Children may eat smaller portions and can vomit due to limited space in the abdomen.[childliverdisease.org]
    • Ascites causes abdominal pain, swelling, nausea, vomiting, and other difficulties.[urmc.rochester.edu]
    • Other symptoms often include: Shortness of breath Nausea Swelling in legs and ankles Indigestion Vomiting Heartburn Loss of appetite Infection Hernia If you have any of these symptoms, see your doctor.[webmd.com]
    • […] disease Uncommonly found in hypothyroidism History of alcohol use Tuberculosis Symptoms of ascites Symptoms of ascites include: Sudden weight gain Swollen abdomen Difficulty breathing when lying down Diminished appetite Abdominal pain Bloating Nausea and vomiting[belmarrahealth.com]
    • Symptoms don’t always signal an emergency, but you should talk to your doctor if you experience the following: sudden weight gain a distended (swollen) abdomen difficulty breathing when lying down diminished appetite abdominal pain bloating nausea and vomiting[healthline.com]
    Nausea
    • Proper positioning may help nausea as the stomach empties toward the right and many patients are less prone to nausea when lying on their right side.[pancan.org]
    • Ascites causes abdominal pain, swelling, nausea, vomiting, and other difficulties.[urmc.rochester.edu]
    • Other symptoms often include: Shortness of breath Nausea Swelling in legs and ankles Indigestion Vomiting Heartburn Loss of appetite Infection Hernia If you have any of these symptoms, see your doctor.[webmd.com]
    • This can cause: pain and discomfort nausea (feeling sick) indigestion and reduced appetite feeling full tiredness breathlessness.[macmillan.org.uk]
    • Ovary disease Uncommonly found in hypothyroidism History of alcohol use Tuberculosis Symptoms of ascites Symptoms of ascites include: Sudden weight gain Swollen abdomen Difficulty breathing when lying down Diminished appetite Abdominal pain Bloating Nausea[belmarrahealth.com]
    Abdominal Distension
    • Progressive weakness and abdominal distension.[thepoultrysite.com]
    • Clinical features Patients present with abdominal distension; fluid may be detected on physical examination with shifting dullness.[bestpractice.bmj.com]
    • Patients with a large volume of ascites can present with abdominal distension (which may be painful), nausea, vomiting, dyspnoea and peripheral oedema 7, 9 .[radiopaedia.org]
    • Symptoms Most patients who develop ascites notice abdominal distension and rapid weight gain.[patients.gi.org]
    Loss of Appetite
    • The fluid causes pressure on other organs in the abdominal area and may lead to: clothes feeling tighter or needing a bigger belt size bloating abdominal pain back pain difficulty sitting comfortably and moving around loss of appetite indigestion constipation[cancerresearchuk.org]
    • Other symptoms often include: Shortness of breath Nausea Swelling in legs and ankles Indigestion Vomiting Heartburn Loss of appetite Infection Hernia If you have any of these symptoms, see your doctor.[webmd.com]
    • This can cause: Rapid weight gain Loss of appetite Shortness of breath Pain in the abdomen Heartburn Development of hernias (groin, navel) It is often accompanied by swelling in the legs and ankles (edema).[dartmouth-hitchcock.org]
    Increased Abdominal Girth
    • A 65-year-old man with a history of myocardial infarction is admitted for decreased exercise tolerance, increased abdominal girth, and ankle edema.[jamaevidence.mhmedical.com]
    • Patients can complain of increasing abdominal girth, generalized abdominal pain and shortness of breath.[cancertherapyadvisor.com]
    • abdominal girth, early satiety, and respiratory distress depending on the amount of fluid accumulated in the abdomen.[hepatitiscentral.com]
    • As more fluid accumulates, increased abdominal girth and size are commonly seen.[medicinenet.com]
    Early Satiety
    • satiety, and respiratory distress depending on the amount of fluid accumulated in the abdomen.[hepatitiscentral.com]
    • If a large amount of fluid is present, the patient might complain of abdominal fullness, early satiety, abdominal pain, or shortness of breath.[clevelandclinicmeded.com]
    Peritoneal Disease
    • Peritoneal diseases including infectious peritonitis and malignancies can also cause ascites.[bestpractice.bmj.com]
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  • respiratoric
    Pleural Effusion
    • CXR may show pleural effusion, evidence of pulmonary metastases or heart failure.[patient.info]
    • A patient will also have lower limb edema and pleural effusion (fluid passing between the two layers of the pleura, which covers the lungs).[health.ccm.net]
    • The accumulation of fluid may cause breathing difficulties by compressing the diaphragm or forming a pleural effusion .[medicinenet.com]
    • Pleural effusion and hydrothorax can also occur (below).[sisbib.unmsm.edu.pe]
    • Meigs syndrome is a benign tumor of the ovary called a fibroma that presents with ascites and pleural effusion (fluid in the cavities surrounding the lungs).[emedicinehealth.com]
    Dyspnea
    • People with ascites may experience the following symptoms: Weight gain Shortness of breath, also called dyspnea Abdominal swelling Sense of fullness or bloating Sense of heaviness Indigestion Nausea or vomiting Changes to the belly button Hemorrhoids,[cancer.net]
    • This crowding upward of the diaphragm gives rise to more or less dyspnea, and the patient soon finds himself unable to lie down.[henriettes-herb.com]
    • Patients with ascites due to heart failure tend to waken in the middle of the night, with paroxysmal nocturnal dyspnea (dys abnormal pnea breathing).[emedicinehealth.com]
    • Treatment of ascites can dramatically improve quality of life by decreasing abdominal discomfort or dyspnea, or both.[clevelandclinicmeded.com]
    Orthopnea
    • The shortness of breath tends to be worse with activity and with lying flat (orthopnea).[emedicinehealth.com]
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  • Entire body system
    Weight Gain
    • A 57-year-old woman presents with an adnexal mass and recent weight gain but otherwise feels well.[jamaevidence.mhmedical.com]
    • Try to avoid drinking excess water, which can lead to additional swelling and weight gain.[belmarrahealth.com]
    • Nevertheless, Packed Cell Volume, weight gain and feed efficiency were not affected by the treatment ( Table 1 ).[scielo.br]
    • Symptoms Ascites is usually accompanied by a feeling of fullness, a ballooning belly, and rapid weight gain .[webmd.com]
    • This can cause: Rapid weight gain Loss of appetite Shortness of breath Pain in the abdomen Heartburn Development of hernias (groin, navel) It is often accompanied by swelling in the legs and ankles (edema).[dartmouth-hitchcock.org]
    Whipple Disease
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  • Workup

    Pathology

    Biopsy
    Hepatocellular Carcinoma
    • There are a wide variety of causing liver tissue damaged such as alcoholic cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), hepatocellular carcinoma to name a few.[alfapump.com]
    • High serum hepatitis B viral levels are associated with an increased risk of progression to cirrhosis and hepatocellular carcinoma; experts and guidelines have endorsed maximal HBV viral suppression with antiviral therapy to reduce this risk.[depts.washington.edu]
    • The usual causes are: Malignancies of the gastrointestinal tract (carcinoma of stomach, colon, pancreas; primary hepatocellular carcinoma and metastatic liver cancer).[patient.info]
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  • Laboratory

    Pleura
    Pleural Effusion
    • CXR may show pleural effusion, evidence of pulmonary metastases or heart failure.[patient.info]
    • A patient will also have lower limb edema and pleural effusion (fluid passing between the two layers of the pleura, which covers the lungs).[health.ccm.net]
    • The accumulation of fluid may cause breathing difficulties by compressing the diaphragm or forming a pleural effusion .[medicinenet.com]
    • Pleural effusion and hydrothorax can also occur (below).[sisbib.unmsm.edu.pe]
    • Meigs syndrome is a benign tumor of the ovary called a fibroma that presents with ascites and pleural effusion (fluid in the cavities surrounding the lungs).[emedicinehealth.com]
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  • Imaging

    X-ray
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  • Treatment

    Prognosis

    Complications

    Portal Vein Thrombosis
    • Flow to the umbilicus (rare, in portal vein thrombosis).[stanfordmedicine25.stanford.edu]
    • vein thrombosis Congestive heart failure Acute renal failure Active encephalopathy Alcoholic hepatitis Pregnancy Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff[clinicaltrials.gov]
    • Aetiology Causes of transudative ascites: hepatic cirrhosis alcoholic hepatitis heart failure (CCF) hypoproteinaemia portal vein thrombosis peritoneal dialysis malignancy ( 10% of refractory ascites) 7, 9 most commonly: breast, ovarian , endometrial,[radiopaedia.org]
    • Other conditions that can cause this problem include: Clots in the veins of the liver (portal vein thrombosis) Congestive heart failure Pancreatitis Thickening and scarring of the sac-like covering of the heart Kidney dialysis may also be linked to ascites[nlm.nih.gov]
    Budd-Chiari Syndrome
    • Budd-Chiari Syndrome Neoplasm, Local Coagulopathy Neoplastic association Collagen Vascular Disease - eg.[enotes.tripod.com]
    • Other causes Causes of portal hypertension other than cirrhosis include congestive heart failure, constrictive pericarditis, alcoholic hepatitis, fulminant hepatitis, subacute hepatitis, massive liver metastasis, and Budd-Chiari syndrome, which may be[bestpractice.bmj.com]
    • Causes and risk factors of ascites Causes and risk factors of ascites are largely in part due to liver conditions, including: Cirrhosis Acute liver failure Budd-Chiari syndrome Liver cancer Hepatitis B or C Other causes include: Heart failure Nephritic[belmarrahealth.com]
    • This may reveal the size and shape of the abdominal organs, and Doppler studies may show the direction of flow in the portal vein, as well as detecting Budd-Chiari syndrome (thrombosis of the hepatic vein) and portal vein thrombosis .[en.wikipedia.org]
    • Pathogenic Mechanisms in Ascites Formation A) Increased hydrostatic pressure Cirrhosis Hepatic vein occlusion (Budd-Chiari syndrome) Inferior vena cava obstruction Constrictive pericarditis Congestive heart failure B) Decreased colloid osmotic pressure[hepatitiscentral.com]
    Proteinuria
    • HRS is established in a patient with a creatinine of 1.5mg/dl that does not improve with withdrawal of diuretics, volume expansion with albumin, absence of obstructive or parenchymal renal disease (indicated by ultrasonography, proteinuria), and absence[clevelandclinicmeded.com]
    Acute Pancreatitis
    • Acute pancreatitis ( inflammation of the pancreas ) can cause fluid accumulation as part of the inflammatory response.[emedicinehealth.com]
    • Pancreatic ascites can also be caused by acute pancreatitis as well as trauma to the pancreas.[medicinenet.com]
    Hypokalemia
    • In the event of marked hyponatremia, hyperkalemia or hypokalemia, renal insufficiency, dehydration, or encephalopathy, diuretics should be reduced or discontinued.[clevelandclinicmeded.com]
    Hepatitis
    • Patients with chronic hepatitis B infection who have negative hepatitis B e antigen are not always by definition “healthy carriers.”[depts.washington.edu]
    • The Hepatitis C Help Book .[liversupport.com]
    • Transudative (Serum Albumin - Ascites Albumin 1.1gm/dl) Heart Failure Group Alcoholic Liver Disease (Micronodular Cirrhosis, Alcoholic Hepatitis) Hepatic Necrosis Hepatic Vein Thrombosis (Budd-Chiari Syndrome) or IVC Obstruction Portal Vein Occlusion[enotes.tripod.com]
    • Other causes Causes of portal hypertension other than cirrhosis include congestive heart failure, constrictive pericarditis, alcoholic hepatitis, fulminant hepatitis, subacute hepatitis, massive liver metastasis, and Budd-Chiari syndrome, which may be[bestpractice.bmj.com]
    Peritonitis
    Hepatocellular Carcinoma
    • There are a wide variety of causing liver tissue damaged such as alcoholic cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), hepatocellular carcinoma to name a few.[alfapump.com]
    • High serum hepatitis B viral levels are associated with an increased risk of progression to cirrhosis and hepatocellular carcinoma; experts and guidelines have endorsed maximal HBV viral suppression with antiviral therapy to reduce this risk.[depts.washington.edu]
    • The usual causes are: Malignancies of the gastrointestinal tract (carcinoma of stomach, colon, pancreas; primary hepatocellular carcinoma and metastatic liver cancer).[patient.info]
    Liver Failure
    Alcoholic Hepatitis
    • Other causes Causes of portal hypertension other than cirrhosis include congestive heart failure, constrictive pericarditis, alcoholic hepatitis, fulminant hepatitis, subacute hepatitis, massive liver metastasis, and Budd-Chiari syndrome, which may be[bestpractice.bmj.com]
    • hepatitis ( ICD-10-CM Diagnosis Code K70.11 Alcoholic hepatitis with ascites 2016 2017 2018 Billable/Specific Code Adult Dx (15-124 years) K70.11 ) ascites in toxic liver disease with chronic active hepatitis ( ICD-10-CM Diagnosis Code K71.51 Toxic liver[icd10data.com]
    • Albumin serum-ascites gradient serum albumin - ascitic albumin - Gradient of 1.1 g/dL suggests portal hypertension; seen in cirrhosis, alcoholic hepatitis, CHF, massive liver metastasis, fulminant liver failure, portal-veiin thrombosis, Budd-Chiari synd[enotes.tripod.com]
    • hepatitis Pregnancy Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.[clinicaltrials.gov]
    • Aetiology Causes of transudative ascites: hepatic cirrhosis alcoholic hepatitis heart failure (CCF) hypoproteinaemia portal vein thrombosis peritoneal dialysis malignancy ( 10% of refractory ascites) 7, 9 most commonly: breast, ovarian , endometrial,[radiopaedia.org]
    Tuberculosis
    • When mononuclear cells predominated , tuberculosis or fungal infection is likely.[hepatitiscentral.com]
    • – 2% or spontaneous bacterial peritonitis Pancreatitis – 1% Serositis Nephrotic syndrome [6] Hereditary angioedema [7] Other rare causes: Meigs syndrome Vasculitis Hypothyroidism Renal dialysis Peritoneum mesothelioma Abdominal tuberculosis Mastocytosis[en.wikipedia.org]
    • Acute liver failure Budd-Chiari syndrome Liver cancer Hepatitis B or C Other causes include: Heart failure Nephritic syndrome Pancreas disorders Direct irritation of the peritoneum Ovary disease Uncommonly found in hypothyroidism History of alcohol use Tuberculosis[belmarrahealth.com]
    • Some causes of liver damage include: cirrhosis hepatitis B or C a history of alcohol use Other conditions that may increase your risk of ascites include: ovarian, pancreatic, liver, or endometrial cancer heart or kidney failure pancreatitis tuberculosis[healthline.com]
    • […] peritoneal dialysis malignancy ( 10% of refractory ascites) 7, 9 most commonly: breast, ovarian , endometrial, gastrointestinal and pancreatic 7 Causes of exudative ascites: peritoneal carcinomatosis pancreatitis abscess nephrotic syndrome peritonitis , e.g. tuberculosis[radiopaedia.org]
    Portal Hypertension
    Nephrotic Syndrome
    • When clinically detectable, ascites may indicate underlying heart failure, liver disease, nephrotic syndrome, or malignancy.[jamaevidence.mhmedical.com]
    • Conditions causing hypo-albuminemia such as nephrotic syndrome and protein-losing enteropathy may result in ascites.[bestpractice.bmj.com]
    • Syndrome Serositis Bowel obstruction or infarction Treatment Monitoring The treatment of ascites depends on it’s cause.[hepatitiscentral.com]
    • Due to infections Nephrotic syndrome Meig's ovarian tumor syndrome Constrictive pericarditis Inferior vena cava obstruction Viral hepatitis with submassive or massive hepatic necrosis B.[enotes.tripod.com]
    • syndrome peritonitis , e.g. tuberculosis ischaemic bowel bowel obstruction Plain radiograph Detection of intraperitoneal fluid on a plain radiograph requires at least 500 mL to be present.[radiopaedia.org]
    Edema
    • […] of larynx ( J38.4 ) edema of nasopharynx ( J39.2 ) edema of pharynx ( J39.2 ) gestational edema ( O12.0- ) hereditary edema ( Q82.0 ) hydrops fetalis NOS ( P83.2 ) hydrothorax ( J94.8 ) hydrops fetalis NOS ( P83.2 ) newborn edema ( P83.3 ) pulmonary[icd10data.com]
    • A patient will also have lower limb edema and pleural effusion (fluid passing between the two layers of the pleura, which covers the lungs).[health.ccm.net]
    • A 65-year-old man with a history of myocardial infarction is admitted for decreased exercise tolerance, increased abdominal girth, and ankle edema.[jamaevidence.mhmedical.com]
    • If the ascites is due to heart failure , there may be shortness of breath as well as leg swelling (edema).[emedicinehealth.com]
    Whipple Disease
    Hemochromatosis
    • Serum Albumin - Ascites Albumin 1.1gm/dl) Heart Failure Group Alcoholic Liver Disease (Micronodular Cirrhosis, Alcoholic Hepatitis) Hepatic Necrosis Hepatic Vein Thrombosis (Budd-Chiari Syndrome) or IVC Obstruction Portal Vein Occlusion Meig's Syndrome Hemochromatosis[enotes.tripod.com]
    Viral Hepatitis
    • Due to infections Nephrotic syndrome Meig's ovarian tumor syndrome Constrictive pericarditis Inferior vena cava obstruction Viral hepatitis with submassive or massive hepatic necrosis B.[enotes.tripod.com]
    • Alcoholic liver disease or alcoholic hepatitis (hepar liver itis inflammation), viral hepatitis (B or C), and fatty liver disease are the most common causes for cirrhosis .[emedicinehealth.com]
    • The medical history may provide clues to the underlying cause and typically includes questions about previous diagnosis of liver disease, viral hepatitis infection and its risk factors, alcohol abuse, family history of liver disease, heart failure, cancer[medicinenet.com]
    Umbilical Hernia
    • Only patients with clinically tense symptomatic ascites (shortness of breath, umbilical hernia, abdominal pain and/or distension, and/or limitation of activity) who have either diuretic-resistant ascites or diuretic-intractable ascites are being studied[clinicaltrials.gov]
    • The high intra-abdominal pressure may push out an umbilical hernia or even an inguinal hernia.[patient.info]
    • Sometimes the belly button can be pushed outwards (umbilical hernia).[childliverdisease.org]
    Right-Sided Heart Failure
    • Portal hypertension is usually caused by liver cirrhosis or, less commonly, outflow obstruction from right-sided heart failure or Budd-Chiari syndrome.[clevelandclinicmeded.com]
    Hepatitis B
    • Patients with chronic hepatitis B infection who have negative hepatitis B e antigen are not always by definition “healthy carriers.”[depts.washington.edu]
    • Causes and risk factors of ascites Causes and risk factors of ascites are largely in part due to liver conditions, including: Cirrhosis Acute liver failure Budd-Chiari syndrome Liver cancer Hepatitis B or C Other causes include: Heart failure Nephritic[belmarrahealth.com]
    • Get vaccinated for hepatitis B.[healthline.com]
    • History of chronic hepatitis B or hepatitis C (or risk factors for these diseases).[patient.info]
    • B, and pneumococcal pneumonia Talk to your doctor about all medicines you take, including herbs and supplements and over-the-counter medicines Procedures that you may have are: Inserting a needle into the belly to remove large volumes of fluid (called[nlm.nih.gov]
    Hepatorenal Syndrome
    • The authors describe measures for the control of ascites as well as strategies for its management and for the prevention of major complications, including gastrointestinal bleeding, spontaneous bacterial peritonitis, and the hepatorenal syndrome.[nejm.org]
    • (February 2017) Hepatorenal syndrome [ edit ] This section is empty.[en.wikipedia.org]
    • Complications may include: Spontaneous bacterial peritonitis (a life-threatening infection of the ascites fluid) Hepatorenal syndrome (kidney failure) Weight loss and protein malnutrition Mental confusion, change in the level of alertness, or coma (hepatic[nlm.nih.gov]
    • EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis.[psnet.ahrq.gov]
    Spontaneous Bacterial Peritonitis
    • ‘Patients who have cirrhosis with ascites are prone to spontaneous bacterial peritonitis.’[oxforddictionaries.com]
    • The authors describe measures for the control of ascites as well as strategies for its management and for the prevention of major complications, including gastrointestinal bleeding, spontaneous bacterial peritonitis, and the hepatorenal syndrome.[nejm.org]
    • Ascites and spontaneous bacterial peritonitis.[nlm.nih.gov]
    • Complications [ edit ] Spontaneous bacterial peritonitis [ edit ] This section is empty.[en.wikipedia.org]
    Wilson Disease
    • Causes of Ascites Ascites can be caused by a number of conditions including: * Alcoholism with cirrhosis * Hepatitis * Cancer of the liver * Wilson’s disease * Cystic fibrosis * Blood clots in the portal vein * Pancreatitis * Kidney disease * Congestive[alcoholrehab.com]
    Kidney Disease
    • Diseases (NIDDK) Keywords provided by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): refractory ascites paracenteses Additional relevant MeSH terms: Liver Cirrhosis Ascites Liver Diseases Digestive System Diseases Pathologic[clinicaltrials.gov]
    • Ascites can also be caused by cancer, heart failure, kidney disease, or pancreatic disease.[dartmouth-hitchcock.org]
    • Causes of Ascites Ascites can be caused by a number of conditions including: * Alcoholism with cirrhosis * Hepatitis * Cancer of the liver * Wilson’s disease * Cystic fibrosis * Blood clots in the portal vein * Pancreatitis * Kidney disease * Congestive[alcoholrehab.com]
    • Other potential risk factors are related to the other underlying conditions, such as congestive heart failure, malignancy , and kidney disease .[medicinenet.com]

    Etiology

    Causes

    Hypokalemia
    • In the event of marked hyponatremia, hyperkalemia or hypokalemia, renal insufficiency, dehydration, or encephalopathy, diuretics should be reduced or discontinued.[clevelandclinicmeded.com]
    Hemochromatosis
    • Serum Albumin - Ascites Albumin 1.1gm/dl) Heart Failure Group Alcoholic Liver Disease (Micronodular Cirrhosis, Alcoholic Hepatitis) Hepatic Necrosis Hepatic Vein Thrombosis (Budd-Chiari Syndrome) or IVC Obstruction Portal Vein Occlusion Meig's Syndrome Hemochromatosis[enotes.tripod.com]
    Liver Cirrhosis
    • Ascites Liver Cirrhosis Procedure: Transjugular intrahepatic portasystemic shunts (TIPS) Procedure: Total paracentecis (TP) Phase 3 Study Type : Interventional (Clinical Trial) Allocation: Randomized Masking: None (Open Label) Primary Purpose: Treatment[clinicaltrials.gov]
    • ‘Signs and symptoms are primarily those of liver cirrhosis and ascites.’[oxforddictionaries.com]
    • When a liver cirrhosis patient is suffering from thrombosis, it is not possible to perform a liver transplant, unless the thrombosis is very minor.[en.wikipedia.org]
    • The chief factor contributing to ascites in liver cirrhosis is portal hypertension .[link.springer.com]
    • Ascites is an indicator of advanced liver disease and liver cirrhosis.[belmarrahealth.com]
    Wilson Disease
    • Causes of Ascites Ascites can be caused by a number of conditions including: * Alcoholism with cirrhosis * Hepatitis * Cancer of the liver * Wilson’s disease * Cystic fibrosis * Blood clots in the portal vein * Pancreatitis * Kidney disease * Congestive[alcoholrehab.com]

    Epidemiology

    Sex distribution
    Age distribution

    Pathophysiology

    Prevention

    Summary

    Patient Information

    Other symptoms

    Meigs Syndrome
    • Syndrome, Struma ovarii) B.[enotes.tripod.com]
    • Bacterial peritonitis Malignant disease of the peritoneum D) Leakage of fluid into the peritoneal cavity Bile ascites Pancreatic ascites(secondary to a leaking pseudocyst) Chylous ascites Urine ascites E) Miscellaneous causes Myxedema Ovarian disease(Meigs[hepatitiscentral.com]
    • Carcinoma of ovary: Meigs' syndrome is a rare complication of ovarian cancer and produces ascites out of all proportion to the size of the tumour and pleural effusions, often unilateral.[patient.info]
    • Meigs syndrome is a benign tumor of the ovary called a fibroma that presents with ascites and pleural effusion (fluid in the cavities surrounding the lungs).[emedicinehealth.com]
    Alcoholic Liver Disease
    • This is the final stage of alcoholic liver disease and it means that the liver had been damaged beyond its ability to repair itself.[alcoholrehab.com]
    • The mainstay to managing patients with ascites is modest salt restriction, treatment with diuretic therapy, and cessation of alcohol in patients with alcoholic liver disease.[psnet.ahrq.gov]
    • Transudative (Serum Albumin - Ascites Albumin 1.1gm/dl) Heart Failure Group Alcoholic Liver Disease (Micronodular Cirrhosis, Alcoholic Hepatitis) Hepatic Necrosis Hepatic Vein Thrombosis (Budd-Chiari Syndrome) or IVC Obstruction Portal Vein Occlusion[enotes.tripod.com]
    • Alcoholic liver disease or alcoholic hepatitis (hepar liver itis inflammation), viral hepatitis (B or C), and fatty liver disease are the most common causes for cirrhosis .[emedicinehealth.com]
    Hereditary Angioedema

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    References

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    2. Chylous ascites following abdominal aortic aneurysmectomy. Management with total parenteral hyperalimentation. - AH Meinke - Annals of surgery, 1979 - ncbi.nlm.nih.gov
    3. Cerebrospinal fluid ascites: a complication of a ventriculoperitoneal shunt - DF Dean, IB Keller - Journal of Neurology, Neurosurgery & Psychiatry, 1972 - jnnp.bmj.com
    4. Acute portal vein thrombosis unrelated to cirrhosis: A prospective multicenter follow‐up study - A Plessier, S Darwish‐Murad - , 2009 - Wiley Online Library
    5. Cutaneous and soft-tissue manifestations of sepsis due to gram-negative enteric bacilli - DM Musher - Review of Infectious Diseases, 1980 - cid.oxfordjournals.org
    6. Cancer antigen 125 in patients with chronic liver disease - H Devarbhavi, D Kaese, AW Williams, J Rakela - Mayo Clinic , 2002 - Elsevier
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    8. Ascites and right pleural effusion: demonstration of a peritoneo-pleural communication - J Verreault, S Lepage, G Bisson, A Plante - J Nucl Med, 1986 - ukpmc.ac.uk
    9. Acetazolamide and Chlorothiazide in the Treatment of Ascites Due to Cirrhosis of the Liver - RM Myerson, RE Stout, AL Forte - New England Journal of , 1959 - Mass Medical Soc
    10. Acute renal failure in patients with cirrhosis: perspectives in the age of MELD - R Moreau, D Lebrec - Hepatology, 2003 - Wiley Online Library
    11. Acute fatty liver of pregnancy with hepatic coma and Mallory-Weiss Syndrome: report of a case - PA Douvres, WS Rosenthal, P Metzger - Digestive Diseases and , 1965 - Springer
    12. Of angiotensin II and norepinephrine and blood pressure, electrolyte balance, and aldosterone and cortisol secretion in normal man and in cirrhosis with ascites - RP Ames, AJ Borkowski, AM Sicinski - Journal of Clinical , 1965 - ncbi.nlm.nih.gov
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    19. Abdominal wall hernias in the setting of cirrhosis - J Belghiti, F Durand - Seminars in liver disease, 2008 - thieme-connect.com
    20. Cell-free transmission in adult Swiss mice of a disease having the character of a leukemia - C Friend - The Journal of experimental medicine, 1957 - jem.rupress.org
    21. Abdominal distension alters regional pleural pressures and chest wall mechanics in pigs in vivo - T Mutoh, WJ Lamm, LJ Embree - Journal of Applied , 1991 - Am Physiological Soc
    22. ABC of heart failure: clinical features and complications - RDS Watson, CR Gibbs, GYH Lip - BMJ: British Medical Journal, 2000 - ncbi.nlm.nih.gov
    23. Abdominal pain and alcohol celiac plexus nerve block - GE THOMPSON, DC MOORE, LD BRIDENBAUGH - Anesthesia & , 1977 - IARS
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