Abstract
Ascites is often the index presentation of decompensation in patients with cirrhosis . The presence of ascites is an important cause of morbidity and mortality as well as healthcare utilization. The treatment of ascites revolves around the combination of lifestyle changes, diuretic therapy, and, in severe cases, more invasive techniques. In this chapter, we describe the evaluation and management of a patient with new-onset ascites. We also highlight the differential diagnosis of ascites.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Further Reading
Badillo R, Rockey DC. Hepatic hydrothorax. Medicine. 2014;93:135–42.
Biecker E. Diagnosis and therapy of ascites in liver cirrhosis. World J Gastroenterol. 2011;17(10):1237–48.
Boyer TD, Haskal ZJ. AASLD practice guidelines: the role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension. Hepatology. 2010;51:1–16.
Cattau EL, Benjamin SB, Knuff TE, Castell DO. The accuracy of the physical examination in the diagnosis of suspected ascites. JAMA. 1982;247:1164–6.
Chang Y, Qi X, Li Z, Wang F, Wang S, Zhang Z, Xiao C, Ding T, Yang C. Int J Clin Exp Pathol. 2013;6:2523–8.
Coelho JCU, Claus CMP, Campos ACL, Costa MAR, Blum C. Umbilical hernia in patients with liver cirrhosis: a surgical challenge. World J Gastrointest Surg. 2016;8:476–82.
D-Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol. 2006;44:217–31.
Fortune B, Cardenas A. Ascites, refractory ascites and hyponatremia in cirrhosis. Gastroenterol Rep. 2017;5:104–12.
Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American association for the study of liver diseases. Hepatology. 2017;65:310–35.
Hernaez R, Hamilton JP. Unexplained ascites. Am Assoc for the Study of Liver Dis. 2016;7:53–6.
Huang LL, Xia HHX, Zhu SL. Ascitic fluid analysis in the differential diagnosis of ascites: focus on cirrhotic ascites. J Clin Transl Hepatol. 2014;2:58–64.
EASL clinical practice guidelines: the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53:397–417.
Moctezuma-Velazquez C, Kalainy S, Abraldes JG. Beta-blockers in patients with advanced liver disease: has the dust settled? Liver Transpl. 2017;23:1058–69.
Patel YA, Muir AJ. Evaluation of new-onset ascites. JAMA. 2016;316:340–1.
Pose E, Cardenas A. Translating our current understanding of ascites management into new therapies for patients with cirrhosis and fluid retention. Dig Dis. 2017;35:402–10.
Runyon BA. AASLD practice guidelines: management of adult patients with ascites due to cirrhosis: update 2012. Am Assoc for the Study of Liver Dis. 2013;57:1651–3.
Runyon BA, Montano AA, Akriviadis EA, Antillon MR, Irving MA, McHutchison JG. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med. 1992;117:215–20.
Williams JW, Simel DL. The rational clinical examination. Does this patient have ascites? How to divine fluid in the abdomen. JAMA. 1992;267:2645–8.
Disclosure
The authors of this manuscript have no conflicts of interest to disclose.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Corson, M., Najarian, L.M., Saab, S. (2019). Ascites. In: Cohen, S., Davitkov, P. (eds) Liver Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-98506-0_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-98506-0_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-98505-3
Online ISBN: 978-3-319-98506-0
eBook Packages: MedicineMedicine (R0)