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Related Experiment Video

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The bm12 Inducible Model of Systemic Lupus Erythematosus SLE in C57BL/6 Mice

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[Ascites].

Soung Won Jeong¹

¹Department of Internal Medicine, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, Korea.

The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi

|August 28, 2018

Summary

Ascites, a common cirrhosis complication, stems from renal sodium retention. Treatment involves sodium restriction, diuretics, and paracentesis, with liver transplantation for refractory cases.

Area of Science:

Hepatology
Gastroenterology
Internal Medicine

Background:

Ascites is the most frequent decompensation event in cirrhosis, affecting 5-10% of compensated patients annually.
Pathophysiology involves renal sodium retention driven by the renin-angiotensin-aldosterone and sympathetic nervous systems due to reduced effective volume from splanchnic vasodilation.

Purpose of the Study:

To review current diagnostic and treatment strategies for cirrhotic ascites.
To highlight the prognostic implications of refractory ascites.

Main Methods:

Diagnostic paracentesis is recommended for new-onset grade 2 or 3 ascites and hospitalized patients with cirrhosis complications.
Serum-ascites albumin gradient (SAAG) ≥1.1 g/dL accurately identifies portal hypertension (approx. 97% accuracy).

Keywords:

Ascites Hypertension portal Liver cirrhosis

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Main Results:

Standard treatment for grades 1-3 ascites includes sodium restriction, diuretics, and large-volume paracentesis.
Refractory ascites carries a poor prognosis, with a median survival of about six months.

Conclusions:

First-line treatment for refractory ascites involves repeated large-volume paracentesis with albumin.
Liver transplantation is indicated for refractory ascites, and careful patient selection is crucial for transjugular intrahepatic portosystemic shunt efficacy.