Ascites

Ascites
Other names	Peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum, abdominal dropsy[1]
The abdomen of a person with cirrhosis that has resulted in massive ascites and prominent superficial veins
Pronunciation	/əˈsaɪtiːz/, ə-SY-teez[2]
Specialty	Gastroenterology
Symptoms	Increased abdominal size, increased weight, abdominal discomfort, shortness of breath[3]
Complications	Spontaneous bacterial peritonitis, hepatorenal syndrome, low blood sodium[3][4]
Causes	Liver cirrhosis, cancer, heart failure, tuberculosis, pancreatitis, blockage of the hepatic vein[4]
Diagnostic method	Physical exam, ultrasound, CT scan[3]
Treatment	Low-salt diet, medications, draining the fluid[3]
Medication	Spironolactone, furosemide[3]
Frequency	>50% of people with cirrhosis[4]

Ascites (/əˈsaɪtiz/;^[5] Greek: ἀσκός, romanized: askos, meaning "bag" or "sac"^[6]) is the abnormal build-up of fluid in the abdomen.^[1] Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur.^[4] Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath.^[3] Complications can include spontaneous bacterial peritonitis.^[3]

In the developed world, the most common cause is liver cirrhosis.^[4] Other causes include cancer, heart failure, tuberculosis, pancreatitis, and blockage of the hepatic vein.^[4] In cirrhosis, the underlying mechanism involves high blood pressure in the portal system and dysfunction of blood vessels.^[4] Diagnosis is typically based on an examination together with ultrasound or a CT scan.^[3] Testing the fluid can help in determining the underlying cause.^[3]

Treatment often involves a low-salt diet, medication such as diuretics, and draining the fluid.^[3] A transjugular intrahepatic portosystemic shunt (TIPS) may be placed but is associated with complications.^[3] Attempts to treat the underlying cause, such as by a liver transplant, may be considered.^[4] Of those with cirrhosis, more than half develop ascites in the ten years following diagnosis.^[4] Of those in this group who develop ascites, half will die within three years.^[4]