Ascites
| Ascites | |
|---|---|
| Synonyms | peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum, abdominal dropsy |
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| The abdomen of a person with cirrhosis showing massive ascites and prominent superficial veins | |
| Pronunciation | /əˈsaɪtiːz/, ə-SY-teez, /əˈsʌɪtiːz/ |
| Classification and external resources | |
| Specialty | Gastroenterology |
| ICD-10 | R18 |
| ICD-9-CM | 789.5 |
| DiseasesDB | 943 |
| MedlinePlus | 000286 |
| eMedicine | ped/2927 med/173 |
| Patient UK | Ascites |
| MeSH | D001201 |
Ascites is a gastroenterological term for an accumulation of fluid in the peritoneal cavity that exceeds 25 mL.
Although most commonly due to cirrhosis, severe liver disease or metastatic cancer, its presence can be a sign of other significant medical problems, such as Budd–Chiari syndrome. Diagnosis of the cause is usually with blood tests, an ultrasound scan of the abdomen, and direct removal of the fluid by needle or paracentesis (which may also be therapeutic). Treatment may be with medication (diuretics), paracentesis, or other treatments directed at the cause. The term is from Greek askítes meaning "baglike".
Mild ascites is hard to notice, but severe ascites leads to abdominal distension. Patients with ascites generally will complain of progressive abdominal heaviness and pressure as well as shortness of breath due to mechanical impingement on the diaphragm.
Ascites is detected on physical examination of the abdomen by visible bulging of the flanks in the reclining patient ("flank bulging"), "shifting dullness" (difference in percussion note in the flanks that shifts when the patient is turned on the side) or in massive ascites with a "fluid thrill" or "fluid wave" (tapping or pushing on one side will generate a wave-like effect through the fluid that can be felt in the opposite side of the abdomen).
Other signs of ascites may be present due to its underlying cause. For instance, in portal hypertension (perhaps due to cirrhosis or fibrosis of the liver) patients may also complain of leg swelling, bruising, gynecomastia, hematemesis, or mental changes due to encephalopathy. Those with ascites due to cancer (peritoneal carcinomatosis) may complain of chronic fatigue or weight loss. Those with ascites due to heart failure may also complain of shortness of breath as well as wheezing and exercise intolerance.
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