Ascites

• What is ascites?

  Accumulation of fluid in the peritoneal cavity
• What does the development of ascites typically signify?

  Decompensated liver cirrhosis
• What are some causes of SAAG <11 ascites?

  Malignancy - peritoneal carcinomatosis

  Infection - TB

  Hypoalbuminaemia - nephrotic syndrome

  Other - pancreatitis
• What are some causes of SAAG >11 ascites?

  Liver disorders - Cirrhosis, liver failure

  Cardiac - Right heart failure

  Other - Budd-Chiari syndrome
• How is ascites diagnosed?

  Examination

  Ultrasound
• How is ascites managed conservatively?

  Dec dietary sodium

  FLuid restriction if <125 Na2+
• How is ascites managed medically?

  Loop diuretic

  Aldosterone antagonist (spironolactone)

  Antibiotic prophylaxis (reduce risk of SBP)
• How is ascites managed surgically?

  TIPS

  Therapeutic abdo paracentesis