Ascitis
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Ascites refers to an accumulation of fluid in the peritoneal cavity. It is mainly caused by three factors: normal peritoneum conditions like cirrhosis and heart failure; disease of the peritoneum from infections or malignancy; and miscellaneous conditions such as Meig's syndrome or trauma. Clinical features include abdominal distension, difficulty breathing, fever with infections, and weight gain with malignancy. Investigations include ultrasound, diagnostic paracentesis, and lab tests of removed fluid. Management involves salt and water restriction, diuretics, repeated paracentesis, and sometimes peritoneo-venous shunting or TIPSS for resistant cases. Prognosis depends on underlying conditions and risks include renal failure, infection
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This document discusses ascites, which is an accumulation of fluid in the peritoneal cavity. It was first coined by Aulus Cornelius Celsus, a Roman physician from 25 BC to 50 AD. The document covers the definition, pathogenesis, theories of ascites formation, differential diagnosis, management, and laboratory findings of ascites. It discusses how ascites can be caused by portal hypertension, liver damage, infection, or malignancy. Diagnosis involves analyzing ascitic fluid for characteristics like SAAG, cell count, protein level, and LDH to determine the underlying etiology. Management depends on the cause and may include salt restriction, diuretics, beta blockers, paracentesis, or antibiotics.
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- Diagnosis involves physical exam findings like abdominal distension. Imaging like ultrasound can identify fluid levels. Paracentesis analyzes fluid for causes like spontaneous bacterial peritonitis.
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This document provides information on ascites including its definition, causes, diagnosis, and management. Ascites is defined as the accumulation of free fluid in the peritoneal cavity, most often caused by liver cirrhosis (75% of cases), malignancy, or heart failure. Diagnosis involves history, physical exam finding shifting dullness or fluid wave, and abdominal ultrasound or paracentesis. Initial ascites management consists of sodium restriction, diuretics, and large volume paracentesis for refractory ascites.
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This document provides an overview of ascites, including:
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This document provides information on ascites including its definition, causes, diagnosis, and management. Ascites is defined as the accumulation of free fluid in the peritoneal cavity, most often caused by liver cirrhosis (75% of cases), malignancy, or heart failure. Diagnosis involves history, physical exam finding shifting dullness or fluid wave, and abdominal ultrasound or paracentesis. Initial ascites management consists of sodium restriction, diuretics, and large volume paracentesis for refractory ascites.
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Ascitis
- 1. Followusat: facebook.com/groups/NEET.Dental ormail me dr.dkg07@gmail.com Ascitis Accumlation of excess fluid within peritoneal cavity. Caused mainly due to three factors a) Normal peritoneum( transudates) Cirrhosis of with portal hypertension Congestive heart failure Hypotension (Neprhrotic syndrome malnutrition) Pancreatitis Bilary ascites b) Disease peritoneum ( exudates) Tubercular peritonitis Bacterial peritonitis Malignancy (peritoneal/hepatic) c) Miscelleneus Meig’s syndrome Bud-charri syndrome Hyperthyroidism Chylous ascitis i. Filarisis ii. Trauma iii. Tremor Clinical Features Distension of abdomen with/without discomfort or pain Dyspnoea (difficulty in breathing) or orthopnea (respiration performed only at erect posture) GERD FEVER – INFECTIOUS CAUSE Weight increase – malignant cause Fluid thrill and shifting dullness – massice ascitis >1000ml of fluid Other underlying cause Epigastrium and umbilical region – resonant floating Secondary effect Scrotal edema
- 2. Followusat: facebook.com/groups/NEET.Dental ormail me dr.dkg07@gmail.com Pleural effusion – esp right side Functional block of inferior vena cava Cardiac apex raised – increased abdominal pressure on diaphragm Neck veins distension Meralgia paresthesia – numbness or pain in outer theigh (lateral cutaneous nerve of thigh) Invesigation USG – very sensitive Diagnostic paracentesis – needle drainage of fluid Laproscopic & peritoneal biopsy h/p examination of ascitis of fluid o cirrhosis – clear straw colored, light green. o Malignant disease – bloody o Nfectious – cloudy o Biliary communication – heavy bile o Lymphatic obstruction – staining (milky white Neutrophill count – increased Decreased albumin and protein Management a) Salt restriction – diuretic - Furesamide 40-160 mg/day, Spironlactone 100 mg/day b) Weight restriction c) Water 1.0 -1.5 l/day Paracentesis Massive ascitis – IV ALBUMIN (6-8 GM/L of ascitis drained) o 100 ml- 20% HAS every 3l of fluid drained o Not more than 3-5 l of fluid should be drained in a day If all therapy fails then we should opt for Peritoneo-venous shunt: Long tube non return valve – running sub-cutaneously. Peritoneum to internal jugular vein. o Complication: Infection, superior venacava thrombosis, pulmonary edema, DIC o Rarely used. Transjugalar intrahepatic portosystemic stent shunt (TIPSS)
- 3. Followusat: facebook.com/groups/NEET.Dental ormail me dr.dkg07@gmail.com o Resistant ascitis o Not prolonged life – liver transplant waiting p/t Prognosis o Renal failure o Spontaneously bacterial peritonitis o 10-20% wit cirrhosis – 5 year survival