Volume : 11, Issue : 02, February – 2024

Title:

A REVIEW ARTICLE ON ASCITES DISEASE

Authors :

S. Shaheena Begum, Y. Umadevi

Abstract :

Ascites is defined as accumulation of more than 25 ml of fluid in the peritoneal cavity. In Western countries, development of ascites is in 75% of cases due to underlying cirrhosis [European Association for the Study of the Lever, 2010], but other less common etiologist ofascites such as malignancy, congestive heart failure, Budd Chiari syndrome, tuberculosis and pancreatitis should be considered – especially if ascites is the first presenting symptom. Ascites is one of the most frequent complications to cirrhosis occurring in approximately 60% of patients within 10 years of diagnosis [ genial. 1987a]. The development of ascites in the setting of cirrhosis represents a landmark in the natural history of cirrhosis, predicting a poor prognosis with 50% mortality within 3 years [ Fernandez- al. 2001; Guevara et al. 2005]. Consequently, occurrence of ascites signifies the need to consider referral for liver transplantation, which remains the ultimate treatment option of cirrhosis. Ascites formation often develops in cirrhotic patients presenting with acute-on-chronic liver failure (ACLF), which is acute worsening of liver function due to a precipitating event, e.g. infection, upper gastrointestinal bleeding, electrolyte disturbances [2014].Portal hypertension is a prerequisite for development of cirrhotic ascites [Ripoll et al. 2007]. Survival of cirrhosis depends mainly on the degree of portal hypertension, the degree of liver insufficiency and the degree of circulatory dysfunction. The principles behind treatment of ascites include diuretics, paracentesis, insertion of a intrahepatic portosystemic shunt (TIPS), as well as managing complications to ascites such as spontaneous bacterial peritonitis (SBP). SBP occurs in approximately 25% of patients due to bacterial translocation [Wiest and Garcia-Tsao, 2005; Wiest et al. 2014], which is crossing of gut bacteria or bacterial products from the gut lumen to the blood (and ascitic fluid).

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