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Gastrointestinal Conditions > Ascites > Flashcards

Flashcards in Ascites Deck (10):
1

Ascites:

Excessive accumulation of fluid in the abdominal cavity

2

What volume of ascites needs to be present to be detected on clinical examination:

1500mL +

3

Causes of ascites:

* Cirrhosis
* Malignancy (GIT, Meig's)
* Heart failure
* Neprhotic syndrome
* Protein-losing enteropathy
* TB
* Pancreatitis
* Hypothyroidism
* Iatrogenic
e.g. ovarian hyperstimulation in IVF

4

Symptoms of ascites:

* Abdominal distention
* Weight gain
* Discomfort
* Nausea
* Anorexia
* Dyspnoea

5

Signs of ascites:

* Distention
* Fluid thrill
* Shifting dullness
* Umbilical hernia
* Inguinal hernia
* Stigmata of other disease
e.g. Jaundice
* Sister Mary Joseph's nodule
* Virchow's node

6

What is sister Mary Joseph's nodule?

Firm nodule in the umbilicus, suggesting peritoneal carcinomatosis

7

Differential diagnosis of ascites:

* Obesity
* Abdo mass
esp. large cyst

8

Investigations for ascites:

1. Bloods: FBC, U&E, LFTs, Clotting, TFTs

2. Imaging: Abdominal USS, CXR (?pleural effusion, pulmonary mets, HF)

3. Ascitic tap: MC&S

9

Management of ascites:

Rx underlying cause

Pharmacological
* Spironolactone
* Loop diuretics (adjunct)

Surgical
* Therapeutic paracentesis
* TIHPSS (for portal HTN)

10

Complications of ascites:

* Hyponatraemia (dt. diuretics)
* SBP
* Hepatorenal syndrome