Ascites is excess fluid in the space between the tissues lining the abdomen and abdominal organs (the peritoneal cavity).
Cirrhosis and any illness that leads to it is a common cause of ascites. Long-term infections with hepatitis C or B and long-term alcohol abuse are two of the most common causes of cirrhosis.
People with colon cancer, ovarian cancer, endometrial cancer, pancreatic cancer, and liver cancer may develop ascites. Other conditions which may lead to this problem include:
Disorders that may be associated with ascites include:
Kidney dialysis may also be associated with ascites.
When just a small amount of fluid has collected in the belly, there may be no symptoms. Symptoms often develop slowly or suddenly, but a rapid buildup of fluid and symptoms may occur with some causes of ascites.
As more fluid collects, abdominal pain and bloating may occur. When a large amount of ascites is present shortness of breath may develop also.
A physical examination may reveal a swollen abdomen, or belly.
Test to evaluate the liver may be done, including:
Paracentesis or abdominal tap may be performed. This procedure involves using a thin needle to pull fluid from the abdomen. The fluid is tested in various ways to determine the cause of ascites.
The condition that causes ascites will be treated, if possible.
Treatment may include:
Procedures used for ascites that do not respond to medical treatment include:
Patients who develop end-stage liver disease, and whose ascites no longer respond to treatment will need a liver transplant.
Anyone who has ascites and develops new abdominal pain and fever should contact their health care provider immediately.
Portal hypertension - ascites
Runyon BA; AASLD Practice Guidelines Committee. Management of adult patients with ascites due to cirrhosis: an update. Hepatology. 2009;49(6):2087-2107.
Mehta G, Rothstein KD. Health maintenance issues in cirrhosis.Med Clin North Am. 2009;93:901-915.
Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Ausiello D, eds.Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 156.
Reviewed by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California.
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