Ascites is a condition where fluid accumulates in the peritoneal or abdominal cavity. It is most commonly seen in patients with cirrhosis of the liver; however, ascites can also be present in patients with severe congestive heart failure, cancer, or an infection such as tuberculosis.


Patients with ascites typically complain of distention of the abdomen. This may result in difficulty breathing and a poor appetite. It is often seen in association with generalized fluid retention and swelling of the lower extremities.


The diagnosis of ascites is typically made on the basis of physical examination. An imaging study of the abdomen, such as an ultrasound or CT Scan will typically be performed to confirm the diagnosis. Fluid may be removed from the abdominal cavity through a procedure known as paracentesis. A needle is inserted into the peritoneal cavity and fluid is removed for chemical analysis. A large quantity of fluid may also be removed to eliminate symptoms caused by the abdominal extension.


Treatment of ascites is dependent on the underlying cause.  Patients with cirrhosis of the liver, ascites can often be managed by restriction of salt intake and diuretic medications.  Fluid accumulation refractory to these measures may require periodic paracentesis to remove large volumes of fluid.  Occasionally, a patient will require a shunt to allow blood to flow more efficiently through the scarred and cirrhotic liver.

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