Ascites is the most common complication related to cirrhosis and is associated with increased morbidity and mortality. Ascites is a consequence of the loss of compensatory mechanisms to maintain the overall effective arterial blood volume due to worsening splanchnic arterial vasodilation as a result of clinically significant portal hypertension. In order to maintain effective arterial blood vol...

Pathogenesis of Ascites 1517 Cirrhotic Ascites 1517 Noncirrhotic Ascites 1517 Clinical Features 1518 History 1518 Physical Examination 1518 Diagnosis 1519 Abdominal Paracentesis 1519 Ascitic Fluid Analysis 1521 Differential Diagnosis of Ascites 1527 Complications 1528 Ascitic Fluid Infection, Including Spontaneous Bacterial Peritonitis 1528 Cellulitis 1534 Tense Ascites 1535 Pleural Effusions 1...

BACKGROUND & AIMS The MELDNa score was developed to improve the prognostic value of the MELD score in cirrhosis and was built for serum sodium concentrations numerically capped between 125 and 140 mmol/L. This model is not validated in a well-defined population of patients with cirrhosis and refractory ascites in whom severe hyponatremia (≤ 125 mmol/L) is frequent. This study assessed the progn...

EFRACTORY ascites, a term introduced during the R 1950’s to define the ascites not responding to sodium restriction and diuretics, was an extremely frequent condition prior to the 1960’s, when the medical treatment of ascites consisted of the administration of mercurial or thiazide diuretics. These agents have a poor natriuretic effect in patients with marked hyperaldosteronism, who represent a...

A 34-year-old woman with primary chylous ascites due to lymphangiectasias was treated with sclerotherapy of dilated lymphatics and a lymphovenous shunt. She was referred to our institution after a thorough diagnostic and therapeutic approach in her community hospital. After four weeks of intensive diagnostic study, no secondary etiology for her chylous disorder was established. Conservative tre...

Ascites, the collection of fluid in the peritoneal cavity, occurs with a variety of disease states. It is one of the earliest and most common complication of chronic liver disease. In cirrhosis, it is associated with circulatory dysfunction characterized by arterial vasodilatation, high cardiac output and stimulation of vasoactive systems. As appropriate treatment depends on accurate diagnosis,...

Introduction: Schistosomiasis is a tropical parasitic disease with a very high prevalence worldwide, carrying a considerable risk for serious morbidity and mortality. Hepatic schistosomiasis may lead to chronic ascites due to portal hypertension (Increased hydrostatic pressure due to periportal fibrosis). Presentation of Case: We describe the case of a 67-year-old African female with refractory...

We report cases of three patients of refractory ascites without other fluid retention that occurred around five months after allogeneic hematopoietic stem cell transplantation (allo-HSCT). All three patients expired and postmortem examinations revealed unexpected liver fibrosis lacking histological evidences of graft-versus-host-disease (GVHD). The three patients showed normal hepatic function ...

Intractable ascites after orthotopic liver transplantation (OLT) is a relatively rare complication. However, it often takes a life threatening course, which requires re-transplantation. In previous studies, several reports gave hepatic sinusoidal obstruction syndrome (SOS) as one of the causes of refractory ascites. However, the detailed etiology of SOS after OLT and its association with clinic...