TY - JOUR
T1 - Cirrhotic ascites review
T2 - Pathophysiology, diagnosis and management
AU - Moore, Christopher M.
AU - Van Thiel, David H.
PY - 2013/5/1
Y1 - 2013/5/1
N2 - 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.
AB - 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.
KW - Ascites
KW - Cirrhosis
KW - Hepato-hydrothorax
KW - Hepatorenal syndrome
KW - Spontaneous bacterial peritonitis
UR - http://www.scopus.com/inward/record.url?scp=84879151122&partnerID=8YFLogxK
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U2 - 10.4254/wjh.v5.i5.251
DO - 10.4254/wjh.v5.i5.251
M3 - Review article
C2 - 23717736
AN - SCOPUS:84879151122
VL - 5
SP - 251
EP - 263
JO - World Journal of Hepatology
JF - World Journal of Hepatology
SN - 1948-5182
IS - 5
ER -