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    Ascites: Definition

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    Ahmed almahdi
    Ascites is the accumulation of excessive fluid in the peritoneal cavity. It can be caused by portal hypertension, infection, trauma, or other issues like nephrotic syndrome or congestive heart failure that lead to generalized edema. The clinical presentation includes abdominal distension, full flanks, a flat umbilicus, and visible abdominal veins. Diagnostic tests include abdominal ultrasound and paracentesis to analyze the ascitic fluid. Treatment depends on the underlying cause but may include diuretics, albumin infusion, surgery to create shunts, or treatment of any infections present.

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    Ascites: Definition

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    Ahmed almahdi
    17 views2 pages
    Ascites is the accumulation of excessive fluid in the peritoneal cavity. It can be caused by portal hypertension, infection, trauma, or other issues like nephrotic syndrome or congestive heart failure that lead to generalized edema. The clinical presentation includes abdominal distension, full flanks, a flat umbilicus, and visible abdominal veins. Diagnostic tests include abdominal ultrasound and paracentesis to analyze the ascitic fluid. Treatment depends on the underlying cause but may include diuretics, albumin infusion, surgery to create shunts, or treatment of any infections present.

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    Ascites is the accumulation of excessive fluid in the peritoneal cavity. It can be caused by portal hypertension, infection, trauma, or other issues like nephrotic syndrome or congestive heart failure that lead to generalized edema. The clinical presentation includes abdominal distension, full flanks, a flat umbilicus, and visible abdominal veins. Diagnostic tests include abdominal ultrasound and paracentesis to analyze the ascitic fluid. Treatment depends on the underlying cause but may include diuretics, albumin infusion, surgery to create shunts, or treatment of any infections present.

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    17 views2 pages

    Ascites: Definition

    Uploaded by

    Ahmed almahdi
    Ascites is the accumulation of excessive fluid in the peritoneal cavity. It can be caused by portal hypertension, infection, trauma, or other issues like nephrotic syndrome or congestive heart failure that lead to generalized edema. The clinical presentation includes abdominal distension, full flanks, a flat umbilicus, and visible abdominal veins. Diagnostic tests include abdominal ultrasound and paracentesis to analyze the ascitic fluid. Treatment depends on the underlying cause but may include diuretics, albumin infusion, surgery to create shunts, or treatment of any infections present.

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    of 2

    Ascites

    Definition:
    Accumulation of excessive amounts of fluid in the peritoneal cavity.
    Causes:
     Part of generalized edema
     Portal hypertension
     Infection
     Trauma
     Others

    Causes of G.edema:
     NS
     CHF
     Kwashirokor Causes of portal hypertension:
     Hydrops fetalis  Portal vein thrombosis
     Liver cirrhosis
     Pericarditis
    Causes of others:
     CHF
     PUV
     Trauma
    Pathogenesis:  Pancreatitis
     Increased hydrostatic pressure  Lymphatic obstruction Causes of infection:
     Decreased oncotic pressure  Bacterial peritonitis
     + Renin-angiotensin  Tubeculous peritonitis
     ADH
    Clinical picture:
     Abdominal distension
     Full flanks+ dullness
     Flat umbilicus
     Visible veins
     Hydrocele
    Investigations:
     CBC
     LFT
     Protein
     Albumin
     Urine exam
     Chest X- ray
     Abdominal U/S
     Abdominal paracentesis

    Head of P.W. Dr. Noura Noreddeen


    Ascitic fluid appearance
    Appearance Interpretation
    Straw Liver cirrhosis
    Cloudy Bacterial peritonitis
    Perforated bowel
    Pancreatitis
    Bloody Malignancy
    Hemorrhagic peritonitis
    Chylous Lymphoma
    Malignancy
    TB?

    Fluid analysis
    Exudate Transudate
    Sp. Gravity > 1.016 < 1.016
    Protein > 3 gram < 3 gram
    WBCs Many > 300 Few lympho
    RBCs Variable Few

    Ascitic fluid analysis


    Level Interpretation
    Triglyceride Elevated Malignancy, lymphoma, TB
    Parasitic infection, cirrhosis
    Protein 0.3-.0 gdl Normal
    > 4 g/dl TB, SBP
    Glucose 7-10 Normal
    <6 TB, malignancy
    Amylase 50% of serum level Normal
    Increase up to X5 Pancreatitis, pseudocyst, trauma
    serum level
    Alkaline Increased Small bowel perforation
    phosphatase Small bowel strangulation

    Treatment: Causes of ascites: 8 Ps


     Diuretic therapy  Portal HTN
     Nutritional support  Peritonitis
     Albumin I.V. infusion  Pancreatitis
     Surgical shunt intervention:  Peritoneal TB
     Peritoneo-venous shunts  Post-irradiation
     Transjugular intrahepatic porto-systemic shunt  Peritoneal dialysis
     Supportive liver transplantation  Peritoneal carcinoma
     Infection should be treated by specific antibiotic  Peritoneal lymphatic obstruction

    Head of P.W. Dr. Noura Noreddeen

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