Ascites / 대한소화기학회지
The Korean Journal of Gastroenterology
; : 49-55, 2018.
Article
em Ko
| WPRIM
| ID: wpr-716214
Biblioteca responsável:
WPRO
ABSTRACT
Ascites is the most common cause of decompensation in cirrhosis, and 5% to 10% of patients with compensated cirrhosis develop ascites each year. The main factor of ascites formation is renal sodium retention due to activation of the renin-angiotensin-aldosterone system and sympathetic nervous system by the reduced effective volume secondary to splanchnic arterial vasodilation. Diagnostic paracentesis is indicated in all patients with a new onset of grade 2 or 3 ascites and in those admitted to hospital for any complication of cirrhosis. A serum-ascites albumin gradient of ≥1.1 g/dL indicates portal hypertension with an accuracy of approximately 97%. Sodium restriction, diuretics, and large volume paracentesis are the mainstay of treatment in grade 1 to 3 ascites. The refractoriness of ascites is associated with a poor prognosis with a median survival of approximately six months. Repeated large volume paracentesis plus albumin is the first line treatment, and liver transplantation is recommended in patients with refractory ascites. A careful selection of patients is also important to obtain the beneficial effects of transjugular intrahepatic portosystemic shunts in refractory ascites. This review details the recent diagnosis and treatment of cirrhotic ascites.
Palavras-chave
Texto completo:
1
Índice:
WPRIM
Assunto principal:
Prognóstico
/
Ascite
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Sistema Renina-Angiotensina
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Sódio
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Sistema Nervoso Simpático
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Vasodilatação
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Fibrose
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Derivação Portossistêmica Cirúrgica
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Transplante de Fígado
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Paracentese
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
Ko
Revista:
The Korean Journal of Gastroenterology
Ano de publicação:
2018
Tipo de documento:
Article