The management of ascites
The management of ascites
This chapter discusses the development and management of ascites, which is the accumulation of fluid in the abdomen. It is common in patients with epithelial malignancies such as ovarian and endometrial cancers, and is often responsible for the multiplication of debilitating symptoms. Ascites develops as a result of a malignant process or secondary to an unrelated co-morbidity. Assessment of people with ascites requires close attention to all the domains of patient care, including physical, psychological, social, and practical issues. Determination of ascites involves history and physical examinations as well as imaging to confirm existence of small fluids. To determine the aetiology and the management strategies for ascites, diagnostic paracentesis and calculation of serum-ascites albumin gradient are crucial. In managing ascites the goals of the patient and the pathophysiology of fluid collection, including the associated burdens of treatment, should be strictly considered to deliver the best treatment. Some of the management strategies discussed herein include: chemotherapy; sodium and fluid balance; dietary management; and diuretics. To manage burdens caused by interventions, therapeutic paracentesis, implanted external catheters, and transjugular intrahepatic portosystematic shunt (TIPS) are required.
Keywords: ascites, accumulation of fluid, abdomen, assessment, history examinations, physical examinations, diagnostic paracentesis, serum-ascites albumin, fluid collection
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