ABC of diseases of liver, pancreas, and biliary system: Portal hypertension{---}2. Ascites, encephalopathy, and other conditions

doi:10.1136/bmj.322.7283.416

BMJ 2001;322:416-418 ( 17 February )

Clinical review

ABC of diseases of liver, pancreas, and biliary system

Portal hypertension $---$ 2. Ascites, encephalopathy, and other conditions

J E J Krige, I J Beckingham.

The first 150 words of the full text of this article appear below.

	Ascites

Ascites is caused by cirrhosis in 75% of cases, malignancy in 10%, and cardiac failure in 5%; other causes account for theremaining 10%. In most patients the history and examination willgive valuable clues to the cause of the ascites $---$ for example, signsof chronic liver disease, evidence of cardiac failure, or a pelvicmass. The formation of ascites in cirrhosis is due to a combinationof abnormalities in both renal function and portal and splanchniccirculation. The main pathogenic factor is sodium retention. Abouthalf of patients with cirrhosis develop ascites during 10 yearsof observation. The development of ascites is an important eventin chronic liver disease as half of cirrhotic patients with ascitesdie within two years.

Table Removed (Available Only in the Full Text)

Diagnosis
Ascites may not be clinically detectable whenpresent in small volumes. In larger volumes, the classic findingsof ascites are a distended abdomen with a fluid thrill or shifting. . . [Full text of this article]

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