Pathophysiologic factors and management of ascites.
Surg Gynecol Obstet
; 176(2): 191-202, 1993 Feb.
Article
en En
| MEDLINE
| ID: mdl-8421810
ABSTRACT
Ascites is a manifestation of cirrhosis-induced portal hypertension. Pathogenesis is the result of a complex interaction of mechanical, humoral and neural events. Impaired excretion of sodium by the kidney is a hallmark of ascites, which is addressed by many of the available treatment options. Ascites contributes significantly to the morbidity and mortality rates of cirrhosis by increasing the likelihood of such fatal complications as variceal bleeding, hepatorenal syndrome and spontaneous bacterial peritonitis. Most ascitic patients respond to conservative or medical treatment. Five to 10 percent of the patients are refractory and may be candidates for surgical treatment. Peritoneovenous shunting is effective, and while safety is improved by following certain guidelines, its impact on survival is not clear. Portacaval shunting is also safe and effective. The use is accompanied by a prohibitively high morbidity rate because of encephalopathy, which limits its application despite what seems to be a significant impact on survival.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Ascitis
Tipo de estudio:
Guideline
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Surg Gynecol Obstet
Año:
1993
Tipo del documento:
Article