Ascites
Ascites refers to the buildup of excess fluid inside the abdomen.
Common Causes:
Ascites can develop due to several conditions, including:
- Liver failure
- Tuberculosis
- Cancers involving the abdominal lining (peritoneal malignancy)
- Heart failure
- Nephrotic syndrome
- Systemic Lupus Erythematosus (SLE)
Diagnosis:
Ascites is usually confirmed through an ultrasound.
To determine the exact cause, doctors may perform tests such as:
- CECT abdomen
- Peritoneal biopsy
- Laparoscopy
- Ascitic fluid analysis, including:
- ADA, TLC/DLC
- Cytology
- Protein/albumin levels
- AFB and TB culture
Management:
Treatment depends on what is causing the fluid buildup.
In patients with chronic liver disease, the presence of ascites indicates advanced liver damage. These patients are generally treated with diuretics and salt restriction, and many may eventually need a liver transplant.
If the fluid becomes infected, the condition is called Spontaneous Bacterial Peritonitis (SBP). SBP requires IV antibiotics, albumin, and later oral antibiotics. Patients with SBP are also considered for liver transplantation.
- Tubercular ascites is treated with anti-tuberculosis therapy (ATT).
- Malignant ascites is managed with chemotherapy targeting the underlying cancer.