Ascites

Collection of fluid in abdominal cavity is called as ascites.

Common causes are:

• Liver failure
• Heart failure
• Nephrotic syndrome
• Tuberculosis
• Peritoneal malignancy
• Systemic Lupus Erythematosus

Diagnosis

• Ultrasonography helps in confirming the diagnosis

Other tests are

• CECT abdomen
• Peritoneal biopsy
• Ascites fluid evaluation
• ADA
• Cytology Protein/albumin
• AFB and TB culture
• Laparoscopy
• TLC/DLC

Management

Management is oriented towards the specific etiology

• Patients with chronic liver disease who have ascites are patients with advanced diseases. Treatment includes diuretics and salt restriction. Liver transplantation is also recommended in some patients.
• Patients with liver diseases can have infection of ascites, known as Spontaneous Bacterial Peritonitis (SBP). Treatment is by IV antibiotics, and albumin initially, later followed by oral antibiotics. Liver transplantation is recommended in patients with SBP.
• Tubercular ascites is treated by antituberculous treatment (ATT)
• Malignant ascites can be treated with chemotherapy