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Ascites

Ascites

DefinitionAscites is the buildup of fluid inside the peritoneal cavity. It occurs when fluid moves out of the vascular system faster than the peritoneal lymphatics can remove it. This fluid shift is most commonly seen in liver cirrhosis but can also appear in several other systemic disorders.EtiologyCirrhosis remains the leading cause of ascites. Other conditions that can contribute include:Heart failureConstrictive pericarditisAbdominal cancersNephrotic syndromeSevere protein–calorie...

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In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...

Pleural Effusion II: Symptoms and Management

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Intestinal Obstruction II: Pathophysiology

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...

Cirrhosis II: Pathophysiology

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Updated: May 23, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

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Malignant ascites: pathophysiology and treatment.

Emanuel Cavazzoni¹, Walter Bugiantella, Luigina Graziosi

¹Section of General and Emergency Surgery, Department of Surgery, Santa Maria della Misericordia Hospital, University of Perugia, School of Medicine, Via Gerardo Dottori, 1, 06132, Perugia, Italy. emanuelcavazzoni@hotmail.com

International Journal of Clinical Oncology

|March 31, 2012

Summary

Malignant ascites (MA) management presents challenges due to limited treatment efficacy and risks. Further research is needed to establish evidence-based guidelines for this condition.

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Area of Science:

Oncology
Gastroenterology
Palliative Care

Background:

Malignant ascites (MA) is a common complication of various cancers, significantly impacting patient quality of life.
MA symptoms include protein loss, electrolyte imbalances, edema, and increased sepsis risk.
Current treatment options for MA offer limited efficacy and carry inherent risks.

Purpose of the Study:

To review and analyze existing medical, interventional, and surgical treatments for malignant ascites.
To identify current challenges and unmet needs in MA management.
To assess the evidence base for various MA treatment modalities.

Main Methods:

Comprehensive literature review across major databases (PubMed, Medline, Embase, Cochrane Library).
Analysis of studies on medical therapies (paracentesis, diuretics, intraperitoneal treatments), surgical interventions (peritoneal-venous shunts), and palliative procedures (laparoscopic HIPEC).

Main Results:

First-line treatments like paracentesis and diuretics have limitations in efficacy and patient comfort.
Promising medical therapies (chemotherapy, immunotherapy) require further clinical validation.
Surgical options like peritoneal-venous shunts are rarely used due to high complication rates.
Laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) shows potential but lacks extensive study.
No treatment modality for MA has undergone rigorous evidence-based clinical trials.

Conclusions:

Current management of malignant ascites lacks standardized, evidence-based guidelines.
There is a critical need for further research and clinical trials to establish effective and safe treatment protocols for MA.
Optimizing palliative care and exploring novel therapeutic approaches are essential for improving patient outcomes.