Ascites causes

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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], M.Umer Tariq [3], Carlos A Lopez, M.D. [4]


Life-threatening causes of ascites are acute liver failure, hepatic failure, and hepatorenal syndrome. Common causes of ascites are Budd-Chiari syndrome, malignancy, and cirrhosis. Less common causes of ascites are the conditions which may lead to fetal ascites, neonatal ascites, and infantile ascites.


Life Threatening Causes

Common Causes

Less common causes

Causes of fetal ascites[1][2][3][4][5]

Causes of neonatal ascites[6][7][8][9]

Causes of infants and children ascites[10][11][12][13]

Causes by Organ System

Cardiovascular Arteriovenous fistula, Budd-Chiari syndrome, Cardiac amyloidosis, Cardiomegaly, Cardiomyopathy, Cholesterol pericarditis, Congestive heart failure, Constrictive pericarditis, Congestive heart failure, Constrictive pericarditis, Tuberculous pericarditis, Chylous ascites, Cor pulmonale, Diffuse neonatal hemangiomatosis, Endomyocardial fibrosis, Heart failure, Inferior vena cava web, Lymphatic obstruction, Lymphangioma, Kaposiform hemangio-endothelioma, Inferior vena cava syndrome, Pericarditis, Right heart failure, Tricuspid insufficiency, Tricuspid regurgitation, Tricuspid stenosis, Tricuspid valve disease, Veno-occlusive disease, Ventriculoperitoneal shunt, Waldmann disease.
Chemical / poisoning No underlying causes
Dermatologic Cutis marmota telangictatica congenita
Drug Side Effect Acyclovir, Mercaptopurine, Pramipexole, Thalidomide
Ear Nose Throat No underlying causes
Endocrine Hypothyroidism, Thyroxine deficiency, Ovarian hyperstimulation syndrome
Environmental No underlying causes
Gastroenterologic Acute liver failure, Acute pancreatitis, Alcoholic hepatitis, Alcoholic liver disease, Ascending cholangitis, Biliary atresia, Biliary fistula, Budd-Chiari syndrome, Cholangiocarcinoma, Cholecystitis, Cholelithiasis, Chronic hepatitis,Cirrhosis, Colorectal cancer, Congenital liver fibrosis, End stage liver failure, Eosinophilic gastroenteritis, Esophageal cancer, Fitz-Hugh-Curtis syndrome, Fulminant liver failure, Granulomatous peritonitis, Hemochromatosis, Hepatic failure, Hepatic venoocclusive disease with immunodeficiency, Hepatitis, Hepato-biliary diseases, Idiopathic liver cirrhosis, Krukenberg tumor, Liver cancer, Liver damage, Ménétrier's disease, Mosse syndrome, Neonatal hepatitis, Nodular regenerative hyperplasia of the liver, Nutmeg liver, Obliterative portal venopathy, Obstructive jaundice, Pancreatic cancer, Pancreatic fistula, Peritonitis, Portal hypertension, Portal vein occlusion, Portal vein thrombosis, Primary biliary cirrhosis, Primary sclerosing cholangitis, Pseudomyxoma peritonei, Secondary biliary cirrhosis, Severe hepatitis, Stomach cancer, Tuberculous peritonitis, Waldmann disease, Whipple disease
Genetic Niemann-Pick type C
Hematologic Angioimmunoblastic T-cell lymphoma, Banti's Syndrome, Budd-chiari syndrome, Diffuse neonatal hemangiomatosis, Eosinophilic gastroenteritis, Erythroblastosis fetalis , Extramedullary haemopoiesis, Hemolytic disease of the newborn, Mastocytosis, Mosse syndrome, Tang Hsi Ryu syndrome
Iatrogenic Bladder injury from umbilical artery catheterization
Infectious Disease

Alveolar hydatid disease, Amebiasis, Bilharzia, Chronic hepatitis, Chronic viral hepatitis, cytomegalovirus, Echinococcosis, Epstein Barr virus, Filariasis, Fitz-Hugh-Curtis syndrome, acute hepatitis A, Acute hepatitis B, Acute hepatitis C, Acute Hepatitis D, Acute hepatitis E, Herpes simplex infection, Hookworm disease, Kaposiform hemangio-endothelioma, Leptospirosis, Malaria, Portal hypertension in schistosomiasis, Poststreptococcal glomerulonephritis, Rubella virus infection,Schistosomiasis, Hepatosplenic schistosomiasis, Sleeping sickness, Strongyloidiasis, Stuartbras disease, liver disease in syphilis, Toxoplasmosis, Tuberculosis, Tuberculous peritonitis, Tularemia, Whipple disease, Yellow fever virus infection

Musculoskeletal / Ortho No underlying causes
Neurologic No underlying causes
Nutritional / Metabolic

Crigler-Najjar syndrome, Dubin-Johnson syndrome, Gilbert's syndrome, Hemochromatosis, Hypoalbuminemia, Kwashiorkor, Rotor's syndrome, VLCAD deficiency, Wilson's Disease


Meigs' syndrome, Mirror syndrome


Anasarca, Angioimmunoblastic T-cell lymphoma, Angiosarcoma of the liver, Bladder cancer, Cholangiocarcinoma, Cirrhosis of liver, Colorectal cancer, Desmoplastic small round cell tumor, Esophageal cancer, Liver cancer, Liver cirrhosis, Lung cancer, Meig's syndrome, Metastasis, Ovarian cancer, Pancreatic cancer, Pelvic region cancers, Pseudomyxoma peritonei, Stomach cancer, WAGR syndrome, Wilms tumor, Yolk sac tumor,

Opthalmologic No underlying causes
Overdose / Toxicity Vitamin A toxicity
Psychiatric Maternal/fetal abuse

Cor pulmonale, Lung cancer, Mesothelioma, Nephrotic syndrome, Pulmonary hypertension

Renal / Electrolyte

Hepatorenal syndrome, Nephrotic syndrome

Rheum / Immune / Allergy

Chronic bacterial infection, Erythroblastosis fetalis, Eosinophilic gastroenteritis, Eosinophilic peritonitis, Hemolytic disease of the newborn, Hemolytic anemia, Hepatic venoocclusive disease with immunodeficiency, Hepatoma, Immunoproliferative diseases, Primary biliary cirrhosis, Systemic lupus erythematosus

Sexual No underlying causes
Trauma Bladder rupture
Urologic Posterior urethral valves, Ureterocele, Lower ureteral stenosis, Ureteral atresia, Imperforate hymen, Bladder rupture

Hypervolemia, Idiopathic, Metastasis, Obesity hypoventilation syndrome, POEMS syndrome

Causes in Alphabetical Order

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  1. Sun CC, Keene CL, Nagey DA (1990). "Hepatic fibrosis in congenital cytomegalovirus infection: with fetal ascites and pulmonary hypoplasia". Pediatr Pathol. 10 (4): 641–6. PMID 2164662.
  2. Stocker JT (1985). "Congenital cytomegalovirus infection presenting as massive ascites with secondary pulmonary hypoplasia". Hum. Pathol. 16 (11): 1173–5. PMID 2997019.
  3. Patton WL, Lutz AM, Willmann JK, Callen P, Barkovich AJ, Gooding CA (1998). "Systemic spread of meconium peritonitis". Pediatr Radiol. 28 (9): 714–6. doi:10.1007/s002470050449. PMID 9732503.
  4. Dirkes K, Crombleholme TM, Craigo SD, Latchaw LA, Jacir NN, Harris BH, D'Alton ME (1995). "The natural history of meconium peritonitis diagnosed in utero". J. Pediatr. Surg. 30 (7): 979–82. PMID 7472957.
  5. Son M, Walsh CA, Baxi LV (2010). "Prenatal diagnosis of urinary ascites in a fetus with meningomyelocele". Fetal. Diagn. Ther. 28 (1): 61–4. doi:10.1159/000312405. PMID 20389051.
  6. Spriggs, DW; Brantley, RE (1977). "Thoracic and abdominal extravasation: a complication of hyperalimentation in infants". American Journal of Roentgenology. 128 (3): 419–422. doi:10.2214/ajr.128.3.419. ISSN 0361-803X.
  7. Hepworth RC, Milstein JM (1984). "The transected urachus: an unusual cause of neonatal ascites". Pediatrics. 73 (3): 397–400. PMID 6701064.
  8. Keller M, Scholl-Buergi S, Sergi C, Theurl I, Weiss G, Unsinn KM, Trawöger R (2008). "An unusual case of intrauterine symptomatic neonatal liver failure". Klin Padiatr. 220 (1): 32–6. doi:10.1055/s-2007-970591. PMID 18172830.
  9. Gillan JE, Lowden JA, Gaskin K, Cutz E (1984). "Congenital ascites as a presenting sign of lysosomal storage disease". J. Pediatr. 104 (2): 225–31. PMID 6420531.
  10. Gil Z, Beni-Adani L, Siomin V, Nagar H, Dvir R, Constantini S (2001). "Ascites following ventriculoperitoneal shunting in children with chiasmatic-hypothalamic glioma". Childs Nerv Syst. 17 (7): 395–8. PMID 11465792.
  11. Goodman GM, Gourley GR (1988). "Ascites complicating ventriculoperitoneal shunts". J. Pediatr. Gastroenterol. Nutr. 7 (5): 780–2. PMID 3054040.
  12. Zegarra A, García C, Piscoya A, de Los Ríos R, Luis Pinto J, Mayo N, Huerta-Mercado J (2009). "[Eosinophilic enteritis as a rare cause of ascites: case report]". Rev Gastroenterol Peru (in Spanish; Castilian). 29 (3): 272–5. PMID 19898601.
  13. Caine Y, Deckelbaum RJ, Weizman Z, Lijovetsky G, Schiller M (1984). "Congenital hepatic fibrosis--unusual presentations". Arch. Dis. Child. 59 (11): 1094–6. PMC 1628818. PMID 6391392.

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