Ascites-a pathological accumulation of fluid in the abdominal cavity, is one of the main symptoms of decompensated cirrhosis of the liver.
Classification of ascites (International Ascites Club):
1. By degree of development:
- grade 1-fluid in the abdominal cavity is determined only by ultrasound
- grade 2-symmetrical abdominal enlargement.
- grade 3-intense ascites.
2. On the response to medication:
transient (regresses against the background of diuretic therapy)
- resistant (diuretic therapy is ineffective).
Examination plan for a patient with CP with ascites:
1. Physical examination of the patient
2. Ultrasound of the abdominal cavity
3. Performing diagnostic laparocentesis under the control of ultrasound
Complications of ascites:
1. Mechanical complications:
- increased pressure in the portal vein
- vasoconstriction (inferior vena cava syndrome, compression of the renal veins)
- formation of hernias (umbilical, white line of the abdomen)
- the displacement of the organs is intraperitoneal.
2. Bacterial complications: spontaneous bacterial peritonitis.
3. Metabolic complications: impaired electrolyte metabolism.
4. Hepatorenal syndrome.
Basic principles of treatment:
1. Diet (restriction of sodium intake with food to 2 g / day)
2. Strict fluid restriction is not indicated for serum Na content
3. Individual selection of diuretic therapy
4. Therapeutic laparocentesis (see figure)
With the ineffectiveness of therapeutic measures, it is shown:
- Liver transplantation.
- Transjugular intrahepatic portosystemic bypass surgery
Important! Examination and treatment of ascites in the outcome of cirrhosis of the liver is carried out only in specialized clinics under the supervision of qualified doctors!
Do not delay-seek qualified medical help!
Remember that a correct and timely diagnosis guarantees the effectiveness of treatment!
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