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Ascites

What is ascites?

The condition known as ascites is the buildup of fluid in the peritoneal cavity, which is the potential area surrounding the organs in the belly. As a result of numerous illness processes, fluid leaks from blood vessels, which results in ascites.

Risk Factors

The most common cause of ascites is liver injury. The liver's material scars and stiffens as a response of injury from toxins or infection, which causes portal hypertension, or high blood pressure in the liver's blood arteries. As a result of the increased pressure, fluid accumulates in the peritoneal cavity and leaks out of blood vessels.

Conditions and ascites risk factors include:

  • Cirrhosis (liver scarring), which can be caused by:
    • History of alcohol use
    • Hepatitis B or C infection
    • Long term inflammation of the liver
    • Hemochromatosis, or iron overload
  • Cancer of abdominal organs, such as liver, pancreatic, ovarian, uterine, and colon cancer
  • Budd-Chiari syndrome
  • Congestive heart failure
  • Peritonitis, an infection in the abdominal cavity
  • Pancreatitis
  • Tuberculosis

Symptoms

Depending on the degree of abdominal distension, moderate ascites may initially appear to be weight gain until symptoms emerge gradually or suddenly.

  • Abdominal distension
    • Bloating
    • Weight gain or weight loss with increased abdominal distension
  • Abdominal pain
  • Shortness of breath
  • Edema (swelling) in legs
  • Bruising
  • Encephalopathy

Diagnosis

Using an ultrasound or a physical examination, ascites can be found. If the abdomen fluid moves, your doctor may listen for "shifting dullness" to hear if the abdominal sounds change.

Additional exams to monitor organ performance and identify ascites causes include:

  • Paracentesis, a procedure to withdraw abdominal fluid
  • Liver function tests
  • Kidney function tests
  • Blood tests for protein and electrolyte levels

Treatments

  • Paracentesis (removal of abdominal fluid)
  • Pleurex (indwelling catheter to allow at-home drainage of abdominal fluid)
  • TIPS