Ascites
Ascites is the most common cause of decompensation in cirrhosis, and 5% to 10% of patients with compensated cirrhosis develop ascites each year. The main factor of ascites formation is renal sodium retention due to activation of the renin-angiotensin-aldosterone system and sympathetic nervous system...
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| Format: | Article |
| Language: | English |
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Jin Publishing & Printing Co.
2018-08-01
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| Series: | The Korean Journal of Gastroenterology |
| Subjects: | |
| Online Access: | http://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2018.72.2.49 |
| _version_ | 1819107344284385280 |
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| author | Soung Won Jeong |
| author_facet | Soung Won Jeong |
| author_sort | Soung Won Jeong |
| collection | DOAJ |
| description | Ascites is the most common cause of decompensation in cirrhosis, and 5% to 10% of patients with compensated cirrhosis develop ascites each year. The main factor of ascites formation is renal sodium retention due to activation of the renin-angiotensin-aldosterone system and sympathetic nervous system by the reduced effective volume secondary to splanchnic arterial vasodilation. Diagnostic paracentesis is indicated in all patients with a new onset of grade 2 or 3 ascites and in those admitted to hospital for any complication of cirrhosis. A serum-ascites albumin gradient of ≥1.1 g/dL indicates portal hypertension with an accuracy of approximately 97%. Sodium restriction, diuretics, and large volume paracentesis are the mainstay of treatment in grade 1 to 3 ascites. The refractoriness of ascites is associated with a poor prognosis with a median survival of approximately six months. Repeated large volume paracentesis plus albumin is the first line treatment, and liver transplantation is recommended in patients with refractory ascites. A careful selection of patients is also important to obtain the beneficial effects of transjugular intrahepatic portosystemic shunts in refractory ascites. This review details the recent diagnosis and treatment of cirrhotic ascites. |
| first_indexed | 2024-12-22T02:52:33Z |
| format | Article |
| id | doaj.art-d6920d4d1c214d7ea926f24aeeb7e952 |
| institution | Directory Open Access Journal |
| issn | 1598-9992 |
| language | English |
| last_indexed | 2024-12-22T02:52:33Z |
| publishDate | 2018-08-01 |
| publisher | Jin Publishing & Printing Co. |
| record_format | Article |
| series | The Korean Journal of Gastroenterology |
| spelling | doaj.art-d6920d4d1c214d7ea926f24aeeb7e9522022-12-21T18:41:21ZengJin Publishing & Printing Co.The Korean Journal of Gastroenterology1598-99922018-08-01722495510.4166/kjg.2018.72.2.49kjg.2018.72.2.49AscitesSoung Won Jeong0Department of Internal Medicine, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, KoreaAscites is the most common cause of decompensation in cirrhosis, and 5% to 10% of patients with compensated cirrhosis develop ascites each year. The main factor of ascites formation is renal sodium retention due to activation of the renin-angiotensin-aldosterone system and sympathetic nervous system by the reduced effective volume secondary to splanchnic arterial vasodilation. Diagnostic paracentesis is indicated in all patients with a new onset of grade 2 or 3 ascites and in those admitted to hospital for any complication of cirrhosis. A serum-ascites albumin gradient of ≥1.1 g/dL indicates portal hypertension with an accuracy of approximately 97%. Sodium restriction, diuretics, and large volume paracentesis are the mainstay of treatment in grade 1 to 3 ascites. The refractoriness of ascites is associated with a poor prognosis with a median survival of approximately six months. Repeated large volume paracentesis plus albumin is the first line treatment, and liver transplantation is recommended in patients with refractory ascites. A careful selection of patients is also important to obtain the beneficial effects of transjugular intrahepatic portosystemic shunts in refractory ascites. This review details the recent diagnosis and treatment of cirrhotic ascites.http://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2018.72.2.49AscitesLiver cirrhosisHypertension portal |
| spellingShingle | Soung Won Jeong Ascites The Korean Journal of Gastroenterology Ascites Liver cirrhosis Hypertension portal |
| title | Ascites |
| title_full | Ascites |
| title_fullStr | Ascites |
| title_full_unstemmed | Ascites |
| title_short | Ascites |
| title_sort | ascites |
| topic | Ascites Liver cirrhosis Hypertension portal |
| url | http://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2018.72.2.49 |
| work_keys_str_mv | AT soungwonjeong ascites |