Ascites

Question 1

what is the definition of ascites?

Answer 1

Ascites is a pathological collection of fluid in the peritoneal cavity.

Question 2

what are the key presentations of ascites?

Answer 2

risk factors for liver disease
abdo distension
satiety
shortness of breath

Question 3

what investigations should be done for ascites?

Answer 3

Ultrasound, computed tomography scan, or magnetic resonance imaging can confirm the diagnosis.
Grade 1: mild ascites detectable only by ultrasound
Grade 2: moderate ascites with moderate symmetrical distention of abdomen
Grade 3: large or gross ascites with marked abdominal distention

Question 4

what is the aetiology of ascites?

Answer 4

The most common cause of ascites is cirrhosis, followed by congestive heart failure and malignant ascites. Aetiologies can be grouped into two major categories, peritoneal and non-peritoneal.

In cirrhosis, ascites form due to renal dysfunction and abnormalities in portal and splanchnic circulation. Sodium retention is a major factor in pathogenesis.

Other causes of portal hypertension that may be associated with ascites include congestive heart failure, constrictive pericarditis, alcoholic liver disease, fulminant hepatitis, subacute hepatitis, massive liver metastasis, and Budd-Chiari syndrome.

Question 5

what are the differential diagnoses for ascites?

Answer 5

Hepatitis
Alcoholic liver disease
Congestive heart failure 
Nephrotic syndrome
Pancreatitis