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Ascites

Ascites abdomen

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


Presentation

  • Large cystic ovarian tumours can present masquerading as massive ascites and misleading diagnosis as in this case report. We report this case to increase the suspicion index of a large ovarian cyst in all women presenting with massive ascites.[ncbi.nlm.nih.gov]
  • Endometriosis can have several different presentations, including overt ascites and peritonitis; increased awareness can improve diagnostic accuracy and patient outcomes.[ncbi.nlm.nih.gov]
  • The intra-pericardial paraganglioma is very rare and most of them present with hypertension or palpitations.[ncbi.nlm.nih.gov]
  • CASE REPORT A 28-year-old man presented with vague abdominal pain, nonspecific gastrointestinal symptoms, unintentional weight loss, and progressive ascites during the previous several months.[ncbi.nlm.nih.gov]
  • We present a 4-week-old neonate with acute onset of bloody stools and abdominal distention.[ncbi.nlm.nih.gov]
Weight Gain
  • Episodic angio-oedema with eosinophilia (EAE) or Gleich's syndrome is a rare condition characterised by recurrent episodes of oedema and eosinophilia, accompanied by urticaria, fever and weight gain.[ncbi.nlm.nih.gov]
  • A 57-year-old woman presents with an adnexal mass and recent weight gain but otherwise feels well. 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]
  • gain, depending on the amount of abdominal distension.[radiology.ucla.edu]
  • When mycophenolate was recommenced abdominal fullness and weight gain reoccurred. The patient had to be switched to long-term azathioprine treatment. More than 1 year post-conversion the patient remains free of ascites.[ncbi.nlm.nih.gov]
  • Moderate amounts of fluid can increase abdominal girth and cause weight gain, and massive amounts can cause abdominal distention, pressure, and dyspnea; signs may be absent if fluid accumulation is 1500 mL.[merckmanuals.com]
Whipple Disease
  • Diseases of peritoneum : Infections (bacterial, tuberculous, fungal, parasitic), neoplasms, connective tissue disease, miscellaneous (Whipple's disease, familial Mediterranean fever, endometriosis, starch peritonitis, etc.).[accessmedicine.mhmedical.com]
  • Disease, Gynecologic Disease C.[enotes.tripod.com]
Pleural Effusion
  • At a cutoff of 2, the Dengue Score had a positive predictive value (PPV) of 79.03% and a negative predictive value (NPV) of 90.36% for the diagnostic prediction of pleural effusion and/or ascites.[ncbi.nlm.nih.gov]
  • We report a case of refractory right sided pleural effusion which turned out to be HH in the absence of ascites or previous history of cirrhosis.[ncbi.nlm.nih.gov]
  • We present three cases of endometriosis-related ascites, one of them with pleural effusion.[ncbi.nlm.nih.gov]
  • CXR may show pleural effusion, evidence of pulmonary metastases or heart failure. If ultrasound has failed to reveal a cause then MRI scanning may be used. Invasive procedures See separate Ascites Tapping article.[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). Diagnosis The diagnosis of ascites is not easy when manifested in small quantities.[health.ccm.net]
Dyspnea
  • Because of dyspnea, paracentesis was performed in all cases. RESULTS: Median AsI at which patients reported dyspnea was 29.0 cm (range 21.6-38.6 cm). At AsI values less than 21.6 cm, no dyspnea was observed in any of the 12 studied patients.[ncbi.nlm.nih.gov]
  • If ascites results in elevation of the diaphragm, dyspnea may occur. Symptoms of spontaneous bacterial peritonitis (SBP) may include new abdominal discomfort and fever.[merckmanuals.com]
  • Patients with a large volume of ascites can present with abdominal distension (which may be painful), nausea, vomiting, dyspnea and peripheral edema 7, 9 .[radiopaedia.org]
  • Patients with a large volume of ascites can present with abdominal distension (which may be painful), nausea, vomiting, dyspnea and peripheral edema 7,9.[radiopaedia.org]
  • This crowding upward of the diaphragm gives rise to more or less dyspnea, and the patient soon finds himself unable to lie down. Gastric disturbances are common, and constipation is the rule.[henriettes-herb.com]
Orthopnea
  • The shortness of breath tends to be worse with activity and with lying flat (orthopnea). 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]
  • Patients with heart failure usually report paroxysmal nocturnal dyspnea, orthopnea and peripheral edema. Any history of infectious exposures, including tuberculosis, should be queried.[clinicaladvisor.com]
Abdominal Pain
  • At one-month follow-up, the patient reported reduced abdominal pain.[ncbi.nlm.nih.gov]
  • A 53-year-old man with Crohn's disease treated with adalimumab was hospitalised with abdominal pain, fatigue, fever and chills. CT scan of the abdomen showed chronic thickening of the terminal ileum and cecum and new-onset ascites.[ncbi.nlm.nih.gov]
  • Postoperative complications included: infection of the shunt in 3 patients (4.8%), shunt obstruction in 4 (6.4%) and transient abdominal pain in 4 (6.4%). Significant symptomatic relief was obtained in all patients.[ncbi.nlm.nih.gov]
  • All patients were admitted to the hospital because of abdominal pain and dyspnea due to increasing ascites. Ultrasound measurements of ascites extent were performed in four external quadrants of the abdomen. Pockets of free fluid were measured.[ncbi.nlm.nih.gov]
  • We present a challenging case of a woman aged 25 years who presented with nausea, vomiting, diarrhoea, generalised abdominal pain and swelling 8-week following delivery of her first baby.[ncbi.nlm.nih.gov]
Nausea
  • We present a challenging case of a woman aged 25 years who presented with nausea, vomiting, diarrhoea, generalised abdominal pain and swelling 8-week following delivery of her first baby.[ncbi.nlm.nih.gov]
  • Major grade 3 or 4 adverse events were neutropenia (17%), nausea (7%), fatigue (7%), and diarrhea (3%); no treatment-related deaths were observed.[ncbi.nlm.nih.gov]
  • Ascites causes abdominal pain, swelling, nausea, vomiting, and other difficulties.[urmc.rochester.edu]
  • Ascites causes belly pain, swelling, nausea, vomiting, and other problems. Certain things that help prevent cirrhosis of the liver and cancer can also prevent ascites.[urmc.rochester.edu]
Vomiting
  • We present a challenging case of a woman aged 25 years who presented with nausea, vomiting, diarrhoea, generalised abdominal pain and swelling 8-week following delivery of her first baby.[ncbi.nlm.nih.gov]
  • Ascites causes abdominal pain, swelling, nausea, vomiting, and other difficulties.[urmc.rochester.edu]
  • Children may eat smaller portions and can vomit due to limited space in the abdomen. A dietician will be able to advise and support you. CLDF has a leaflet on nutrition with further information.[childliverdisease.org]
  • Ascites causes belly pain, swelling, nausea, vomiting, and other problems. Certain things that help prevent cirrhosis of the liver and cancer can also prevent ascites.[urmc.rochester.edu]
Abdominal Distension
  • Here we report a case of a 46-year-old HIV positive female who presented to us with ascites and abdominal distension with peripheral eosinophilia and diagnosed as EGE.[ncbi.nlm.nih.gov]
  • A 44-year-old woman presented with 3 months' history of painless progressive abdominal distension and weight loss of more than 15 kg. Clinically a pelviabdominal mass with ascites was detected.[ncbi.nlm.nih.gov]
  • Abstract An 81-year-old man was admitted to our hospital with abdominal distension due to refractory ascites of unknown origin. He subsequently died of aspiration pneumonia.[ncbi.nlm.nih.gov]
  • These patients usually present with abdominal distension, pelvic pain, and weight loss, but a careful questioning usually reveals the typical endometriosis symptoms-such as dysmenorrhea and dyspareunia.[ncbi.nlm.nih.gov]
  • Abdominal distension and shifting dullness were present on examination. CT of the abdomen and pelvis was remarkable for moderate-volume ascites and mild enhancement of the pelvic peritoneum.[ncbi.nlm.nih.gov]
Loss of Appetite
  • We describe the case of a 67-year-old patient, a retired person, without significant personal or familial history, nonsmoker, infrequent alcohol and coffee consumer with following chief complaints at onset: loss of appetite, weight loss, serious physical[ncbi.nlm.nih.gov]
  • 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]
  • Abdominal distention, enlarged abdomen, bulging flanks in the abdomen, feeling of heaviness or pressure in the abdomen, loss of appetite, feeling of fullness after any size meal, heartburn, nausea, constipation, shortness of breath, and chronic cough[earthclinic.com]
  • Other symptoms often include: Shortness of breath Nausea Swelling in legs and ankles Indigestion Vomiting Heartburn Loss of appetite Fever Hernia If you have a combination of these symptoms, see your doctor.[webmd.com]
Heart Failure
  • Congestive heart failure has lead to the congestive liver in a young female patient. Regression of all the symptoms of heart failure occurred after surgical treatment (pericardectomy).[ncbi.nlm.nih.gov]
  • A 65-year-old patient was admitted to our institution due to anasarca and pulmonary congestion, mimicking heart failure. We started the patient on diuretics and vasodilators.[ncbi.nlm.nih.gov]
  • Ascites is the most frequent complication of cirrhosis and occurs only when the portal hypertension has already installed but ascites is caused by neoplasms, heart failure, tuberculosis, pancreatic illnesses, as well as other kind of affections.[ncbi.nlm.nih.gov]
  • Collins, Markers of diuretic resistance in emergency department patients with acute heart failure, International Journal of Emergency Medicine, 10, 1, (2017). Martin L. Mai and Hani M.[doi.org]
  • 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.[msdvetmanual.com]
Flank Pain
  • Small amounts may be asymptomatic; increasing amounts cause abdominal distention and discomfort, anorexia, nausea, early satiety, heartburn, flank pain, and respiratory distress.[accessmedicine.mhmedical.com]

Workup

  • Further workup revealed that the patient was HIV-positive and the ascitic tap showed haemorrhagic fluid.[ncbi.nlm.nih.gov]
Hepatocellular Carcinoma
  • Of these, six patients had hepatocellular carcinoma and cirrhosis (5 in PleurX group). None were eligible for insertion of a TIPS or liver transplantation.[ncbi.nlm.nih.gov]
  • Multivariate analysis showed that the presence of viable hepatocellular carcinoma (hazards ratio [HR] 2.14, p 0.02) and a decrease in diuretics were independently prognostic of survival (HR 0.36, p 0.01).[ncbi.nlm.nih.gov]
  • carcinoma ( Cytojournal 2009;6:16 ) Cytology images Images hosted on other servers: Ascites fluid cytology Advertisement[pathologyoutlines.com]
  • Thirty-five patients with refractory ascites related to liver cirrhosis and/or hepatocellular carcinoma (HCC) who underwent PVS placement between February 2005 and February 2013 were included in the study.[ncbi.nlm.nih.gov]
  • BACKGROUND: The majority of patients undergoing hepatectomy for hepatocellular carcinoma (HCC) suffer from underlying liver disease and are exposed to the risk of postoperative ascites, which is favored by an imbalance between portal venous inflow and[ncbi.nlm.nih.gov]
Pleural Effusion
  • At a cutoff of 2, the Dengue Score had a positive predictive value (PPV) of 79.03% and a negative predictive value (NPV) of 90.36% for the diagnostic prediction of pleural effusion and/or ascites.[ncbi.nlm.nih.gov]
  • We report a case of refractory right sided pleural effusion which turned out to be HH in the absence of ascites or previous history of cirrhosis.[ncbi.nlm.nih.gov]
  • We present three cases of endometriosis-related ascites, one of them with pleural effusion.[ncbi.nlm.nih.gov]
  • CXR may show pleural effusion, evidence of pulmonary metastases or heart failure. If ultrasound has failed to reveal a cause then MRI scanning may be used. Invasive procedures See separate Ascites Tapping article.[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). Diagnosis The diagnosis of ascites is not easy when manifested in small quantities.[health.ccm.net]

Treatment

  • Clinicians are well aware of common adverse reactions related to MPA treatment, in particular diarrhea, leukopenia and infections. Here we report a case of severe, persistent ascites associated with MPA treatment.[ncbi.nlm.nih.gov]
  • Improved treatment outcomes for the endometrial cancer patient requires precision methods to investigate the biology of this disease and clinically relevant models to test treatment drugs.[ncbi.nlm.nih.gov]
  • BACKGROUND: The clinical treatment of ovarian cancer with ascites is problematic. The main reasons for treatment failure are the susceptibility to intraperitoneal metastasis and chemotherapeutic drug resistance.[ncbi.nlm.nih.gov]
  • Despite improved medical treatment of ascites, liver transplantation remains the ultimate treatment and early referral of the patient to a highly specialized hepatology unit should always be considered.[ncbi.nlm.nih.gov]
  • The first-line treatment of uncomplicated ascites is a moderate sodium-restricted diet combined with diuretic treatment. In patients who develop refractory ascites, paracentesis plus albumin represents the most feasible option.[ncbi.nlm.nih.gov]

Prognosis

  • Abstract Objective Hyponatremia is frequently observed in patients with decompensated liver cirrhosis and it is also related to a poor prognosis.[ncbi.nlm.nih.gov]
  • The development of ascites carries a significant worsening of the prognosis.[ncbi.nlm.nih.gov]
  • Multivariate logistic regression analysis showed that MELD (p CONCLUSIONS: In this pilot study MIR-FEWS more accurately assess the 6-month prognosis of patients with ascites and cirrhosis than the MELD or Child-Pugh scores.[ncbi.nlm.nih.gov]
  • BACKGROUND: Plasmacytoid urothelial carcinoma (PUC) is a distinct variant of urinary bladder cancer, with a high propensity for invasion and poor prognosis.[ncbi.nlm.nih.gov]
  • The prognosis of patients with noncirrhotic ascites is quite variable . . . Author Affiliations From the Department of Internal Medicine, University of Iowa College of Medicine, Iowa City. Address reprint requests to Dr.[doi.org]

Etiology

  • Eosinophilic gastroenteritis (EGE) is an uncommon disease of unknown etiology reported in both adult and pediatric age group.[ncbi.nlm.nih.gov]
  • Although no areas of active volvulus were identified intraoperatively, findings in the case were suggestive of small bowel volvulus and deemed as the most likely etiology for this patient's presentation.[ncbi.nlm.nih.gov]
  • After ruling out the main causes of ascites, a portal hyperflow was a potential etiology. This condition perpetuates itself with splenic circulation and brings about a reduction in the hepatic arterial flow.[ncbi.nlm.nih.gov]
  • Ascites is a rare complication of multiple myeloma (MM); in most cases, the direct invasion of myeloma cells to the peritoneal cavity has been assumed to be the etiology because the effusion is usually exudative and contains a high proportion of myeloma[ncbi.nlm.nih.gov]
  • Determine etiology by performing laboratory and imaging studies. 5. Evaluate for other etiologies if there are no features of cirrhosis. Diagnostic tests 1.[clinicaladvisor.com]

Epidemiology

  • Ascites secondary to infections and malignancy is a direct result of peritoneal inflammation and possible lymphatic outflow obstruction with a characteristically low SAAG of Epidemiology Chronic liver disease is the twelfth leading cause of death in the[clinicaladvisor.com]
  • This work is supported, in part, by the Kyoto University EBM center, non-profit organization Epidemiological & Clinical Research Information network (ECRIN), and by the Osaka Cancer Research Foundation. References 1.[academic.oup.com]
  • Roger V (2013) Epidemiology of Heart Failure, Circulation Research, 113 :6, (646-659), Online publication date: 30-Aug-2013.[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • This paper summarizes the pathophysiology behind cirrhotic ascites and the diagnostic approaches, as well as outlining the current treatment options.[ncbi.nlm.nih.gov]
  • This review summarizes current knowledge about the pathophysiology of ascites and explains the appropriate approach to clinical evaluation.[doi.org]
  • Florence Wong and Laurence Blendis, THE PATHOPHYSIOLOGIC BASIS FOR THE TREATMENT OF CIRRHOTIC ASCITES, Clinics in Liver Disease, 5, 3, (819), (2001).[doi.org]
  • The recommendations made here are based on pathophysiology and suggest the preferred approach to diagnostic and therapeutic aspects, and preventive care. Sociedad Argentina de Pediatría.[ncbi.nlm.nih.gov]
  • 758 523; 56 KB HRS and ascites pathophysiology-zh.png 824 680; 31 KB Living anatomy and pathology; (1910) (14758293295).jpg 2 748 3 572; 848 KB Manual of antenatal pathology and hygiene - the foetus (1902) (14597904629).jpg 1 710 3 180; 1,81 MB Pathways[commons.wikimedia.org]

Prevention

  • The recommendations made here are based on pathophysiology and suggest the preferred approach to diagnostic and therapeutic aspects, and preventive care. Sociedad Argentina de Pediatría.[ncbi.nlm.nih.gov]
  • Understanding the underlying cause of the condition, however, and finding effective treatment options is crucial to prevent additional issues.[earthclinic.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.[doi.org]
  • Liver transplantation should be considered for all ascitic patients, and this should preferably be performed prior to the development of renal dysfunction to prevent further compromise of their prognosis.[ncbi.nlm.nih.gov]
  • Can ascites be prevented? Certain steps to help you prevent cirrhosis of the liver and cancer can also prevent ascites. These include: Stop drinking alcohol. Stay at a healthy weight. Exercise regularly. Stop smoking. Limit salt intake.[urmc.rochester.edu]

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Last updated: 2014-05-06 22:04