Ascites Flashcards
(27 cards)
What does a SAAG over 11g/L indicate?
Portal hypertension
SAAG stands for Serum-Ascites Albumin Gradient.
What are the common causes of SAAG over 11g/L?
- Liver disorders
- Cardiac issues
- Other causes
Liver disorders include cirrhosis, alcoholic liver disease, acute liver failure, and liver metastases. Cardiac issues include right heart failure and constrictive pericarditis.
List some liver disorders that can cause SAAG over 11g/L.
- Cirrhosis
- Alcoholic liver disease
- Acute liver failure
- Liver metastases
What are some cardiac causes of SAAG over 11g/L?
- Right heart failure
- Constrictive pericarditis
Name other causes of SAAG over 11g/L.
- Budd-Chiari syndrome
- Portal vein thrombosis
- Veno-occlusive disease
- Myxoedema
What does a SAAG less than 11g/L indicate?
Hypoalbuminaemia
SAAG less than 11g/L suggests causes other than portal hypertension.
List the causes of SAAG less than 11g/L.
- Nephrotic syndrome
- Severe malnutrition
- Malignancy
- Infections
- Other causes
Severe malnutrition examples include Kwashiorkor. Other causes can include pancreatitis, bowel obstruction, biliary ascites, postoperative lymphatic leak, and serositis in connective tissue diseases.
What are the management strategies for ascites?
- Reducing dietary sodium
- Fluid restriction
- First line drug: Spironolactone
- Loop diuretics often added
Fluid restriction is sometimes recommended if sodium is < 125 mmol/L.
What is required for large-volume paracentesis treatment of ascites?
Albumin ‘cover’
This is suggested to reduce paracentesis-induced circulatory dysfunction and mortality.
What complications can arise from paracentesis induced circulatory dysfunction?
- Ascites recurrence
- Development of hepatorenal syndrome
- Dilutional hyponatraemia
- High mortality rate
What prophylactic measure is recommended to reduce the risk of spontaneous bacterial peritonitis?
Prophylactic antibiotics
NICE recommends offering prophylactic oral ciprofloxacin or norfloxacin for people with cirrhosis and ascites with an ascitic protein of 15 g/litre or less, until the ascites has resolved.
What is a potential treatment option for certain patients with ascites?
Transjugular intrahepatic portosystemic shunt (TIPS)
TIPS may be considered in some patients with recurrent or severe ascites.
What does a SAAG over 11g/L indicate?
Portal hypertension
SAAG stands for Serum-Ascites Albumin Gradient.
What are the common causes of SAAG over 11g/L?
- Liver disorders
- Cardiac issues
- Other causes
Liver disorders include cirrhosis, alcoholic liver disease, acute liver failure, and liver metastases. Cardiac issues include right heart failure and constrictive pericarditis.
List some liver disorders that can cause SAAG over 11g/L.
- Cirrhosis
- Alcoholic liver disease
- Acute liver failure
- Liver metastases
What are some cardiac causes of SAAG over 11g/L?
- Right heart failure
- Constrictive pericarditis
Name other causes of SAAG over 11g/L.
- Budd-Chiari syndrome
- Portal vein thrombosis
- Veno-occlusive disease
- Myxoedema
What does a SAAG less than 11g/L indicate?
Hypoalbuminaemia
SAAG less than 11g/L suggests causes other than portal hypertension.
List the causes of SAAG less than 11g/L.
- Nephrotic syndrome
- Severe malnutrition
- Malignancy
- Infections
- Other causes
Severe malnutrition examples include Kwashiorkor. Other causes can include pancreatitis, bowel obstruction, biliary ascites, postoperative lymphatic leak, and serositis in connective tissue diseases.
What are the management strategies for ascites?
- Reducing dietary sodium
- Fluid restriction
- First line drug: Spironolactone
- Loop diuretics often added
Fluid restriction is sometimes recommended if sodium is < 125 mmol/L.
What is required for large-volume paracentesis treatment of ascites?
Albumin ‘cover’
This is suggested to reduce paracentesis-induced circulatory dysfunction and mortality.
What complications can arise from paracentesis induced circulatory dysfunction?
- Ascites recurrence
- Development of hepatorenal syndrome
- Dilutional hyponatraemia
- High mortality rate
What prophylactic measure is recommended to reduce the risk of spontaneous bacterial peritonitis?
Prophylactic antibiotics
NICE recommends offering prophylactic oral ciprofloxacin or norfloxacin for people with cirrhosis and ascites with an ascitic protein of 15 g/litre or less, until the ascites has resolved.
What is a potential treatment option for certain patients with ascites?
Transjugular intrahepatic portosystemic shunt (TIPS)
TIPS may be considered in some patients with recurrent or severe ascites.
