TRC: Ascites

Ascites

Ascites is an abnormal accumulation of fluid in the abdominal cavity. The following three factors result in increased fluid transudation and subsequent ascites.

portal hypertension
decreased production of albumin in the liver
decreased clearance by the liver and hyperaldosteronism

With the presence of ascites due to liver failure, the risk for spontaneous bacterial peritonitis (SBP) is increased. This complication arises when the immune system is compromised. With liver cirrhosis, the intestinal wall is more permeable to bacteria.

Albumin and paracentesis treatment is appropriate therapy for a patient with:

Extra info: Patients should receive paracentesis when the amount of ascitic fluid is compromising the patient's respiratory or cardiovascular function. If a patient has developed ascites over a prolonged period (and is indeed diuretic-resistant), then a shunt a more suitable long-term solution. Performing paracentesis in a patient with encephalopathy can lead to further complications due to the resulting hypovolaemia.

Option explanation:

prolonged accumulation of ascites

diuretic resistance with concomitant respiratory compromise

concomitant encephalopathy

any type of ascites, as it is first-line therapy

Ascites

Ascites

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