Ascites Flashcards
what is ascites
collection of fluid within the peritoneal cavity
what is the main cause of ascites
cirrhosis
other causes of ascites
portal hypertension, heart failure, peritonitis
risk factors
risk factors for cirrhosis, Hep C, female sex.
what are the risk factors for Hep C
needle sharing, sharing devices for drug administration / misuse
what do you expect on examination
shifting dullness
investigations
ultrasound of the abdomen, increased bilirubin and worsening coagulation. Thrombocytopenia and serology for Hep A,B and C
why will there be increased bilirubin and worsening coagulation
worsening cirrhosis
why will there be thrombocytopenia (low platelet count)
indicates portal hypertension
medical management of ascites
fluid drainage using a needle or lifestyle changes such as cutting back salt, alcohol and fluid restriction. diuretics might be necessary
what can uncontrolled ascites lead to
peritonitis, renal failure, blood sepsis and pleural effusion
why can uncontrolled ascites lead to pleural effusion
the fluid can migrate to the lungs causing a right-sided pleural effusion because the superior portion of the hepatic surface is in direct contact with the right diaphragm
