Ascites

Question 1

What is ascites?

Answer 1

Abnormal accumulation of fluid in the peritoneal cavity in the abdomen

Question 2

How can ascites be diagnosed?

Answer 2

Clinically by looking

Question 3

What can be done to get a better idea of the cause of ascites?

Answer 3

Ascitic tap

Question 4

What does SAAG stand for?

Answer 4

Serum ascites albumin gradient

Question 5

What can the SAAG be used to determine?

Answer 5

The cause of ascites.

Question 6

How can the SAAG be calculated?

Answer 6

It is calculated by subtracting the albumin concentration of the ascitic fluid from the serum albumin concentration.

Question 7

What is calssified as a high SAAG?

Answer 7

SAAG > 11g/L

Question 8

What does an SAAG >11g/L indicate?

Answer 8

Portal hyertension

Question 9

What are the main hepatic causes of a high SAAG?

Answer 9

Cirrhosis
Budd Chiari syndrome
Hepatic failure

Question 10

What are the cardiac causes of a high SAAG?

Answer 10

Heart failure
Constrictive pericarditis

Question 11

What is a low SAAG?

Answer 11

<11g/L

Question 12

What are the main causes of a low SAAG?

Answer 12

Cancer of the peritoneum
Tuberculosis and other infections
Pancreatitis
Nephrotic syndrome

Question 13

What should be resticed in someone presenting with ascites?

Answer 13

Reduce dietary sodium
fluid restriction if the sodium is < 125 mmol/L

Question 14

What medical management can be used in someone presenting with ascites?

Answer 14

Aldosterone antagonists: e.g. spironolactone

Question 15

What can be used in teh management of recurrent ascites?

Answer 15

Large-volume paracentesis

Question 16

What could be considered for the management of portal hypertension?

Answer 16

Transjugular intrahepatic portosystemic shunt (TIPS)

Question 17

Why would you cosider giving prophylactic antibiotcs for ascites?

Answer 17

Reduce risk of spontaneous bacterial peritonitis