Malignant Ascites in Critically Ill Cancer Patients
Ascites is characterized by the pathological accumulation of fluid in the peritoneal cavity. Malignant ascites is responsible for approximately 10% of all causes of ascites. Ten of 15% of patients with gastrointestinal cancer at some stage develop ascites, and up to 20% of all cases of malignance have unknown primary tumors. Usually it represents an important prognostic factor since most of time it is related to the carcinomatosis, which represents advanced stages or progression of disease in the most of malignancies. The accumulation of malignant cells and proteins from tumor in peritoneal cavity improve the intra-abdominal pressure. Moreover, the evolvement of other system as renal, hepatic, or respiratory can add significant morbidity to critic ill patients. The treatment of intra-abdominal hypertension in patients with ascites can be made puncture and facilitate by image-guided methods. This chapter approaches the main aspects of physiopathology, diagnosis, management, and prognosis of malign ascites in critic ill patients.
KeywordsMalignant ascites Peritoneal cavity Carcinomatosis Peritoneum Accumulation of fluid Intra-abdominal malignance Intra-abdominal hypertension
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