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==Overview==
==Overview==
Mild ascites is hard to notice, but severe ascites leads to [[abdominal distension]]. Patients with ascites generally will complain of progressive abdominal heaviness and pressure as well as [[shortness of breath]] due to mechanical impingement on the [[diaphragm (anatomy)|diaphragm]].
The hallmark of ascites is [[abdominal distention]]. A positive history of [[cirrhosis]] and [[liver failure]] is suggestive of ascites. The most common [[Symptom|symptoms]] of ascites include [[abdominal discomfort]], [[shortness of breath]], and [[weight gain]].
 
Ascites is detected on [[physical examination]] of the abdomen by visible [[Bulging flanks|bulging of the flanks]] in the reclining patient ("flank bulging"), "[[shifting dullness]]" (difference in percussion note in the flanks that shifts when the patient is turned on the side) or in massive ascites with a "fluid thrill" or "[[Fluid wave test|fluid wave]]" (tapping or pushing on one side will generate a wave-like effect through the fluid that can be felt in the opposite side of the abdomen).
 
Other signs of ascites may be present due to its underlying etiology. For instance, in [[portal hypertension]] (perhaps due to cirrhosis or fibrosis of the liver) patients may also complain of leg swelling, bruising, [[gynecomastia]], [[hematemesis]], or mental changes due to [[encephalopathy]]. Those with ascites due to [[cancer]] (peritoneal carcinomatosis) may complain of chronic fatigue or weight loss. Those with ascites due to [[heart failure]] may also complain of shortness of breath as well as wheezing and exercise intolerance.


==History==
*The hallmark of ascites is [[abdominal distention]]. A positive history of [[cirrhosis]] and [[liver failure]] is suggestive of ascites. The most common [[Symptom|symptoms]] of ascites include [[abdominal discomfort]], [[shortness of breath]], and [[weight gain]].<ref name="pmid11056439">{{cite journal |vauthors=Aalami OO, Allen DB, Organ CH |title=Chylous ascites: a collective review |journal=Surgery |volume=128 |issue=5 |pages=761–78 |year=2000 |pmid=11056439 |doi=10.1067/msy.2000.109502 |url=}}</ref>
===History===
Patients with ascites may have a positive history of:<ref name="pmid1467885">{{cite journal |vauthors=Browse NL, Wilson NM, Russo F, al-Hassan H, Allen DR |title=Aetiology and treatment of chylous ascites |journal=Br J Surg |volume=79 |issue=11 |pages=1145–50 |year=1992 |pmid=1467885 |doi= |url=}}</ref>
*[[Acute liver failure]]
*[[Hepatic failure]]
*[[Hepatorenal syndrome]]
*[[Liver]] [[fibrosis]]
*[[Liver cirrhosis]]
*[[Budd-Chiari  syndrome]]
*[[Cancer]]
*[[Cirrhosis]]
*[[Constrictive pericarditis]]
*[[Heart failure]]
*[[Nephrotic syndrome]]
*[[Pancreatitis]]
*[[Serositis]]
*[[Tuberculosis]]
===Common Symptoms===
Common [[symptoms]] of ascites include:<ref name="pmid21398159">{{cite journal |vauthors=Steinemann DC, Dindo D, Clavien PA, Nocito A |title=Atraumatic chylous ascites: systematic review on symptoms and causes |journal=J. Am. Coll. Surg. |volume=212 |issue=5 |pages=899–905.e1–4 |year=2011 |pmid=21398159 |doi=10.1016/j.jamcollsurg.2011.01.010 |url=}}</ref>
*[[Abdominal distension]]
*[[Abdominal discomfort]]
*[[Shortness of breath]]
*[[Weight gain]]
*[[Early satiety]]
*[[Confusion]]
*[[Hematemesis]]
===Less Common Symptoms===
Less common [[symptoms]] of ascites include:<ref name="pmid7059101">{{cite journal |vauthors=Press OW, Press NO, Kaufman SD |title=Evaluation and management of chylous ascites |journal=Ann. Intern. Med. |volume=96 |issue=3 |pages=358–64 |year=1982 |pmid=7059101 |doi= |url=}}</ref>
*[[Weight loss]]
*[[Orthopnea]]
*[[Pedal edema|Peripheral edema]]
*[[Diarrhea]] and [[steatorrhea]]
*[[Malnutrition]]
*[[Edema]]
*[[Nausea]]
*[[Night sweats]]
*[[Bruising]]
*[[Gynecomastia]]
*[[Fatigue]]
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Needs content]]
[[Category: Medicine]]
[[Category: Up-To-Date]]
[[Category: Gastroenterology]]
[[Category: Hepatology]]
[[Category: Emergency medicine]]


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Latest revision as of 16:58, 13 February 2018

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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

The hallmark of ascites is abdominal distention. A positive history of cirrhosis and liver failure is suggestive of ascites. The most common symptoms of ascites include abdominal discomfort, shortness of breath, and weight gain.

History

History

Patients with ascites may have a positive history of:[2]

Common Symptoms

Common symptoms of ascites include:[3]

Less Common Symptoms

Less common symptoms of ascites include:[4]

References

  1. Aalami OO, Allen DB, Organ CH (2000). "Chylous ascites: a collective review". Surgery. 128 (5): 761–78. doi:10.1067/msy.2000.109502. PMID 11056439.
  2. Browse NL, Wilson NM, Russo F, al-Hassan H, Allen DR (1992). "Aetiology and treatment of chylous ascites". Br J Surg. 79 (11): 1145–50. PMID 1467885.
  3. Steinemann DC, Dindo D, Clavien PA, Nocito A (2011). "Atraumatic chylous ascites: systematic review on symptoms and causes". J. Am. Coll. Surg. 212 (5): 899–905.e1–4. doi:10.1016/j.jamcollsurg.2011.01.010. PMID 21398159.
  4. Press OW, Press NO, Kaufman SD (1982). "Evaluation and management of chylous ascites". Ann. Intern. Med. 96 (3): 358–64. PMID 7059101.

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