Cirrhotic ascites review: Pathophysiology, diagnosis and management

Christopher M. Moore*, David H. Van Thiel

*Corresponding author for this work

Research output: Contribution to journalReview article

46 Scopus citations

Abstract

Ascites is a pathologic accumulation of peritoneal fluidcommonly observed in decompensated cirrhotic states. Its causes are multi-factorial, but principally involve significant volume and hormonal dysregulation in the setting of portalhypertension. The diagnosis of ascites is considered in cirrhotic patients given a constellation of clinical and laboratory findings, and ultimately confirmed, with insight into etiology, by imaging and paracentesis procedures. Treatment for ascites is multimodal including dietary sodium restriction, pharmacologic therapies, diagnostic and therapeutic paracentesis, and in certain cases transjugular intra-hepatic portosystemic shunt. Ascites is associated with numerous complications including spontaneous bacterial peritonitis, hepato-hydrothorax and hepatorenal syndrome. Given the complex nature of ascites and associatedcomplications, it is not surprising that it heralds increased morbidity and mortality in cirrhotic patients and increased cost-utilization upon the health-care system. This review will detail the pathophysiology of cirrhotic ascites, common complications derived from it, and pertinent treatment modalities.

Original languageEnglish (US)
Pages (from-to)251-263
Number of pages13
JournalWorld Journal of Hepatology
Volume5
Issue number5
DOIs
StatePublished - May 1 2013

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Keywords

  • Ascites
  • Cirrhosis
  • Hepato-hydrothorax
  • Hepatorenal syndrome
  • Spontaneous bacterial peritonitis

ASJC Scopus subject areas

  • Hepatology

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