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paracentesis

Management of Patients with Ascites

Management of Patients with Ascites

Teaser: 

Karen L. Krok, MD, Assistant Professor of Medicine, Division of Gastroenterology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Andrés Cárdenas, MD, MMSc, Institut de Malalties Digestives i Metaboliques, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.

Ascites is the accumulation of free fluid in the peritoneal cavity. In over 80% of cases, it is a result of cirrhosis. Ascites develops in 60% of patients with cirrhosis within 10 years of the diagnosis of cirrhosis, and its development marks a turning point in the natural history of the disease. The mainstays of treatment are twofold: sodium restriction and diuretics. The development of spontaneous bacterial peritonitis is another ominous sign that requires indefinite antibiotic prophylaxis to prevent future infections. A referral to a transplant centre is essential once ascites or spontaneous bacterial peritonitis develop.
Key words: ascites, portal hypertension, cirrhosis, spontaneous bacterial peritonitis, paracentesis, albumin infusion.