Ascites

Question 1

What is a pathological collection of fluid in the peritoneal space?

Answer 1

Ascites

Question 2

What are the causes of ascites?

Answer 2

1. Cirrhosis (75-80%)
2. Congestive heart failure
3. Neoplasm
4. Hypoalbuminaemia

Question 3

What are the findings on examination in ascites?

Answer 3

1. Early satiety, SOB (rapid accumulation of fluid)
2. Flank bulging and shifting dullness (confirmed by USS/CT/MRI)
3. Elevated JVP suggests cardiac cause
4. Enlarged Virchow’s node = malignancy
5. Pleural effusion? Peritonitis?

Question 4

How is a suspected ascites investigated?

Answer 4

Ascitic fluid tap - albumin, high neutrophils (bacterial peritonitis), gram stain and culture, cytology if cancer suspected.