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Ascites is our topic today so we will start by Ascites definition
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| Ascites and paracentesis |
Definition of Ascites:
Ascites is the collection of excess free fluid in the peritoneal cavity.
Causes of Ascites:
Hepatic :- Liver Cirrhosis.
- Hepatic tumors (hepatocellular carcinoma)
- Hepatocellular carcinoma
- Abdominal or pelvis tumors that may be primary or secondary tumors
- Primary mesothelioma
Cardiac:
Peritonitis:
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Watch this video (paracentesis):
General Investigations:
1. Urine Dipstick: strongly positive for protein in nephrotic syndrome.
2. Complete Blood Count: Raised white cell count may indicate an infection
3. Urea and Electrolytes: Elevated urea and creatinine may indicate a renal etiology
4. LFT’s :in hepatic faliure.
5. Chest X-ray: Findings suggestive of cardiac failure are cardiomegaly.
6. Ultrasound Abdomen: detect any intra abdominal masses that are not palpable on clinical examination. OR fatty deposits in the liver in the presence of cirrhosis.
7. Abdominal Paracentesis: Aspiration of the ascitic fluid is very useful to help determine the underlying cause. A sample should be sent to microbiology clinical chemistry and pathology.
8.Ascitic fluid Examinations.
9.Others:
A. Echocardiography
B. Liver biopsy
C. Renal Biopsy
D. Portal venography
- Congestive Cardiac failure or right heart faliure
- Constrictive pericarditits.
- Tricuspid incompetence (regurge)
Peritonitis:
- Tuberculosis.
- Spontaneous bacterial peritonitis.
- Budd-Chiari syndrome.
- Veno-occlusive disease.
- Hepatic portal vein obstruction.
- Inferior vena cave obstruction.
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- Pancreatitis
- Bile ascites
Watch this video (paracentesis):
General Investigations:
1. Urine Dipstick: strongly positive for protein in nephrotic syndrome.
2. Complete Blood Count: Raised white cell count may indicate an infection
3. Urea and Electrolytes: Elevated urea and creatinine may indicate a renal etiology
4. LFT’s :in hepatic faliure.
5. Chest X-ray: Findings suggestive of cardiac failure are cardiomegaly.
6. Ultrasound Abdomen: detect any intra abdominal masses that are not palpable on clinical examination. OR fatty deposits in the liver in the presence of cirrhosis.
7. Abdominal Paracentesis: Aspiration of the ascitic fluid is very useful to help determine the underlying cause. A sample should be sent to microbiology clinical chemistry and pathology.
8.Ascitic fluid Examinations.
9.Others:
A. Echocardiography
B. Liver biopsy
C. Renal Biopsy
D. Portal venography
Posted in: Emergency,Medical Procedures
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