Flashcards in Ascites Deck (7)
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1
Definition
Collection of fluid in peritoneal cavity
2
Etiology
Hepatitis C
Alcoholic hepatitis
CHF
Nephrotic syndrome
Pancreatitis
Other causes of cirrhosis
Schistosomiasis
Constrictive pericarditis
Ovarian tumors
SLE
Protein losing enteropathy
3
History
Presence/risks of cirrhosis
Risks of hepatitis C
Family history
SOBOE, PND, orthop->CHF
Malignancy
Pancreatitis
Autoimmune disease
4
Physical examination
General
Stigmata of cirrhosis
JVP distension
Abdominal
Peripheral edema
5
Investigations
USS
FBC, LFT, UEC, albumin
Coagulation
Calculate MELD/Chigh Pugh
Serology for hepatitis B, A, C->determine status and need for immunisations
Abdominal paracentesis->cell count, differential, albumin, protein, culture, glucose, LDH, amylase, gram stain, TB smear/culture, cytology
Liver biopsy
6
What in the ascitic fluid suggests non-cirrhotic cause
ascitic fluid albumin gradient is high
Diagnosis based on SAAG:
>1.1g/dL: portal hypertension
Cirrhosis
Portal vein thrombosis
Budd chiari
CHF
Corrective pericarditis
7
