Ascites natural history, complications and prognosis
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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.