Ascites natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
More than half of the patients with [[cirrhosis]] would involve with ascites during the [[disease]]. If left untreated, 11.4% of patients with [[Cirrhosis|cirrhotic]] ascites may progress to develop [[hepatorenal syndrome]] during 5 years. Common [[complications]] of ascites include [[Spontaneous bacterial peritonitis|spontaneous bacterial peritonitis (SBP)]], [[dilutional hyponatremia]], and [[hepatorenal syndrome]]. [[Prognosis]] is generally poor, and the 5-year [[Survival rates|survival rate]] of patients with [[Cirrhosis|cirrhotic]] ascites is approximately 56.6%. | |||
==Natural History== | ==Natural History, Complications, and Prognosis== | ||
Ascites | Ascites may contribute to three grades:<ref>Moore KP, Wong F, Gines P, Bernardi M, Ochs A, Salerno F, Angeli P, Porayko M, Moreau R, Garcia-Tsao G, Jimenez W, Planas R, Arroyo V. The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club. ''Hepatology'' 2003;38:258-66. PMID 12830009.</ref> | ||
* Grade 1: | * Grade 1: Mild accumulation of fluid in [[abdomen]], which is only visible on [[ultrasound]]. | ||
* Grade 2: detectable with flank bulging and shifting dullness | * Grade 2: Moderate accumulation of fluid in [[abdomen]], which is detectable with [[flank]] bulging and [[shifting dullness]]. | ||
* Grade 3: directly visible | * Grade 3: Severe accumulation of fluid in [[abdomen]], which is directly visible with fluid thrill. | ||
===Natural History=== | |||
==Complications== | *More than half of the patients with [[cirrhosis]] would involve with ascites during the [[disease]]. | ||
* [[Spontaneous bacterial peritonitis]] | *The symptoms of refractory ascites typically develop in 11.3% of patients during 5 years of [[cirrhosis]]. | ||
* [[ | *If left untreated, 37.1% of patients with [[Cirrhosis|cirrhotic]] ascites may progress to develop [[dilutional hyponatremia]] during 5 years. | ||
* [[Weight loss]] and protein malnutrition | *If left untreated, 11.4% of patients with [[Cirrhosis|cirrhotic]] ascites may progress to develop [[hepatorenal syndrome]] during 5 years.<ref name="pmid17081806">{{cite journal |vauthors=Planas R, Montoliu S, Ballesté B, Rivera M, Miquel M, Masnou H, Galeras JA, Giménez MD, Santos J, Cirera I, Morillas RM, Coll S, Solà R |title=Natural history of patients hospitalized for management of cirrhotic ascites |journal=Clin. Gastroenterol. Hepatol. |volume=4 |issue=11 |pages=1385–94 |year=2006 |pmid=17081806 |doi=10.1016/j.cgh.2006.08.007 |url=}}</ref> | ||
* | ===Complications=== | ||
* | *Common [[complications]] of ascites include:<ref name="pmid25954497">{{cite journal| author=Pedersen JS, Bendtsen F, Møller S| title=Management of cirrhotic ascites. | journal=Ther Adv Chronic Dis | year= 2015 | volume= 6 | issue= 3 | pages= 124-37 | pmid=25954497 | doi=10.1177/2040622315580069 | pmc=4416972 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25954497 }}</ref> | ||
**[[Spontaneous bacterial peritonitis|Spontaneous bacterial peritonitis (SBP)]] | |||
= | **[[Dilutional hyponatremia]] | ||
**[[Hepatorenal syndrome]] | |||
**[[Weight loss]] and [[protein malnutrition]] | |||
**[[Hepatic encephalopathy]] | |||
===Prognosis=== | |||
*[[Prognosis]] is generally poor, and the 5-year [[Survival rates|survival rate]] of patients with [[Cirrhosis|cirrhotic]] ascites is approximately 56.6%. | |||
*The presence of [[Spontaneous bacterial peritonitis|spontaneous bacterial peritonitis (SBP)]], [[dilutional hyponatremia]], and [[hepatorenal syndrome]] is associated with a particularly poor [[prognosis]] among patients with [[Cirrhosis|cirrhotic]] ascites.<ref name="pmid17081806" /> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category: | [[Category: Medicine]] | ||
[[Category: Up-To-Date]] | |||
[[Category: Gastroenterology]] | |||
[[Category: Hepatology]] | |||
[[Category: Emergency medicine]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 16:56, 13 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
More than half of the patients with cirrhosis would involve with ascites during the disease. If left untreated, 11.4% of patients with cirrhotic ascites may progress to develop hepatorenal syndrome during 5 years. Common complications of ascites include spontaneous bacterial peritonitis (SBP), dilutional hyponatremia, and hepatorenal syndrome. Prognosis is generally poor, and the 5-year survival rate of patients with cirrhotic ascites is approximately 56.6%.
Natural History, Complications, and Prognosis
Ascites may contribute to three grades:[1]
- Grade 1: Mild accumulation of fluid in abdomen, which is only visible on ultrasound.
- Grade 2: Moderate accumulation of fluid in abdomen, which is detectable with flank bulging and shifting dullness.
- Grade 3: Severe accumulation of fluid in abdomen, which is directly visible with fluid thrill.
Natural History
- More than half of the patients with cirrhosis would involve with ascites during the disease.
- The symptoms of refractory ascites typically develop in 11.3% of patients during 5 years of cirrhosis.
- If left untreated, 37.1% of patients with cirrhotic ascites may progress to develop dilutional hyponatremia during 5 years.
- If left untreated, 11.4% of patients with cirrhotic ascites may progress to develop hepatorenal syndrome during 5 years.[2]
Complications
- Common complications of ascites include:[3]
Prognosis
- Prognosis is generally poor, and the 5-year survival rate of patients with cirrhotic ascites is approximately 56.6%.
- The presence of spontaneous bacterial peritonitis (SBP), dilutional hyponatremia, and hepatorenal syndrome is associated with a particularly poor prognosis among patients with cirrhotic ascites.[2]
References
- ↑ Moore KP, Wong F, Gines P, Bernardi M, Ochs A, Salerno F, Angeli P, Porayko M, Moreau R, Garcia-Tsao G, Jimenez W, Planas R, Arroyo V. The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club. Hepatology 2003;38:258-66. PMID 12830009.
- ↑ 2.0 2.1 Planas R, Montoliu S, Ballesté B, Rivera M, Miquel M, Masnou H, Galeras JA, Giménez MD, Santos J, Cirera I, Morillas RM, Coll S, Solà R (2006). "Natural history of patients hospitalized for management of cirrhotic ascites". Clin. Gastroenterol. Hepatol. 4 (11): 1385–94. doi:10.1016/j.cgh.2006.08.007. PMID 17081806.
- ↑ Pedersen JS, Bendtsen F, Møller S (2015). "Management of cirrhotic ascites". Ther Adv Chronic Dis. 6 (3): 124–37. doi:10.1177/2040622315580069. PMC 4416972. PMID 25954497.