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Ascites: what it is and why it occurs

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An important accumulation of small quantities of fluid in the abdomen can cause important pathologies. One is ascites , a consequence of cirrhosis of the liver. It is an effusion or accumulation of fluid in the peritoneal cavity, abdomen and pelvic cavity. In addition to causes directly related to liver disease, ascites may also be caused by conditions not related to the liver. Here are the most common causes of ascites:

 
  • liver conditions
  • tumors
  • heart failure
  • kidney failure
  • tuberculosis
  • pancreatitis

Symptoms are slightly different based on the cause. Those that may be in the initial stages are: 

  • painless or uncomfortable abdominal distension 
  • increase in body weight
  • feeling of satiety
  • wheezing and shortness of breath
  • general tiredness

If the cause is the liver , then stellate angiomas (small spots on the skin), jaundice and muscle atrophy will appear. If the ascites has a bacterial infection , there will also be fever, pain in the abdomen, vomiting and confusion. If there are cancer cells instead, then there will be weight loss. On the other hand, if heart failure occurs, there will be frequent respiratory discomforts such as orthopnea and peripheral oedema. 

The diagnostic tools are ultrasound and CT to detect the fluid. To find out the causes of ascites, the diagnostic paracentesis exam is the most suitable. A detection of the accumulated fluid in the peritoneal cavity with a needle in the abdomen. 

 

In cases where the cause is cirrhosis of the liver , ascites can also lead to death with a 50% increase in mortality . The treatment will focus mainly on reducing the amount of this liquid and peripheral edema. Basic treatment will include dietary sodium restriction, prescription of diuretics, and therapeutic paracentesis with fluid removal. In case of spontaneous bacterial peritonitis, antibiotics will be given. 

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  • Ascites: what causes it and how to treat the accumulation of fluid in the abdomen (ohga.it)

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