Minimizing ascites

PREVIEW Ascites, the pathologic accumulation of fluid in the peritoneal cavity, is a common and serious complication of cirrhosis of the liver. Proper management with a combination of dietary, medical, and surgical approaches is essential to prolong life and improve its quality. In this article, Drs Garcia and Sanyal explain how to prevent and treat this condition and how to recognize potential complications in time to minimize further damage.

[1]  A. Gerbes,et al.  Long‐term therapy and retreatment of hepatorenal syndrome type 1 with ornipressin and dopamine , 1999, Hepatology.

[2]  B. Runyon.  Management of adult patients with ascites caused by cirrhosis , 1998, Hepatology.

[3]  W. Jiménez,et al.  Randomized trial comparing albumin, dextran 70, and polygeline in cirrhotic patients with ascites treated by paracentesis. , 1996, Gastroenterology.

[4]  J. Schölmerich,et al.  Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis , 1996, Hepatology.

[5]  V. Arroyo,et al.  Treatment of patients with cirrhosis and refractory ascites using LeVeen shunt with titanium tip: Comparison with therapeutic paracentesis , 1995, Hepatology.

[6]  G. Grassi,et al.  Time course of circulatory and humoral effects of rapid total paracentesis in cirrhotic patients with tense, refractory ascites. , 1994, Gastroenterology.

[7]  J. McHutchison,et al.  The Serum-Ascites Albumin Gradient Is Superior to the Exudate-Transudate Concept in the Differential Diagnosis of Ascites , 1992, Annals of Internal Medicine.

[8]  T. E. dos Santos,et al.  [Spontaneous bacterial peritonitis]. , 1991, Arquivos de gastroenterologia.

[9]  E. Schiff,et al.  Peritoneovenous shunting as compared with medical treatment in patients with alcoholic cirrhosis and massive ascites. Veterans Administration Cooperative Study on Treatment of Alcoholic Cirrhosis with Ascites. , 1989, The New England journal of medicine.

[10]  B. Runyon,et al.  Optimization of ascitic fluid culture technique. , 1988, Gastroenterology.

[11]  J. Hoefs,et al.  Ascitic fluid analysis in malignancy‐related ascites , 1988, Hepatology.

[12]  G. Bleichner,et al.  Frequency of infections in cirrhotic patients presenting with acute gastrointestinal haemorrhage , 1986, The British journal of surgery.

[13]  J. Kaufman.  Care of patients with ascites. , 1994, New England Journal of Medicine.

[14]  J. Such,et al.  Spontaneous Bacterial Peritonitis , 1997, Seminars in liver disease.