Prise en charge symptomatique de l’ascite maligne en phase palliative: place de la paracentèse et des diurétiques. Supportive care for malignant ascites in. Chez dix patients cirrhotiques porteurs d’une ascite sous tension, la pression voie endoscopique au moyen d’une fine aiguille, avant et après paracentèse. Mr G. presented for acute care 3 weeks ago with tense ascites, which was managed with a large volume paracentesis (LVP) of approximately 4 L. He was.

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Proc Bayl Univ Med Cent ; 26 2: In most cases, ascites is due to peritoneal carcinomatosis in which vascular permeability is enhanced by VEGF production while lymphatic drainage decreases. Despite this, Mr Sacite. The most common indication is ascites that has developed in people with cirrhosis.

First-line therapy includes sodium restriction. This page was last edited on 9 Novemberat Diuretics Second-line therapy includes the use of diuretics. Malignant ascites, occurring in advanced stages of cancer, is linked with poor prognosis and can cause invalidating symptoms.

While paracentesis and diuretics are commonly used, their efficiency has never been compared in a randomized controlled study.

Paracentesis – Wikipedia

The procedure generally is paracntese painful and does not require sedation. Competing interests None declared. Retrieved from ” https: Every 1 to 2 days, Mr G. In other projects Wikimedia Commons. Studies have shown that spironolactone monotherapy and combination therapy with spironolactone and furosemide are equally effective at relieving ascites.



Fundamental to the formation of ascites in cirrhosis are portal hypertension, which causes splanchnic vasodilation, and sscite of the renin-angiotensin-aldosterone system, further resulting in renal sodium retention. Liver Artificial extracorporeal liver support Bioartificial liver devices Liver dialysis Hepatectomy Liver biopsy Liver transplantation Portal sscite Transjugular intrahepatic portosystemic shunt [TIPS] Distal splenorenal shunt procedure.

The patient is requested to urinate before the procedure; alternately, a Foley catheter is used to empty the bladder. Prospective evaluation of the PleurX catheter when used to treat recurrent ascites associated with malignancy. In an expert’s hands it is usually very safe, although there is a small risk of infection, excessive bleeding or perforating a loop of bowel.

If you want to subscribe to this journal, see our rates You can paracentesd this item in Pay Per View: Physiopathological mechanisms of ascites formation are complex and have yet to be fully elucidated. European Association for the Study of the Liver EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis.

Within 7 days, Mr G.

Ascites in patients with cirrhosis

Decision making on the management of ascites depends on the severity of symptoms and not the presence of ascites in and of itself. Definition, features, and investigation Ascites is defined as the presence of excessive fluid in the peritoneal cavity. Anal sphincterotomy Anorectal manometry Lateral internal sphincterotomy Rubber band ligation Transanal hemorrhoidal dearterialization.

Colonoscopy Anoscopy Capsule endoscopy Enteroscopy Proctoscopy Sigmoidoscopy Abdominal ultrasonography Defecography Double-contrast barium enema Endoanal ultrasound Enteroclysis Lower gastrointestinal series Small-bowel follow-through Transrectal ultrasonography Virtual colonoscopy. From Wikipedia, the free encyclopedia.


The natural history of cirrhotic liver disease progresses from a compensated to a decompensated phase. Tunneled catheters are preferred over pigtail catheters owing to stability and lower rates of infection.

Appendicectomy Ascit Colonic polypectomy Colostomy Hartmann’s operation. What the exact risk of infection posed by an indwelling catheter is and whether or not patients require prophylactic antibiotics is not well defined in the literature. Portal hypertension and ascites. Views Read Edit View history.

Ascites in patients with cirrhosis

His abdomen is markedly distended with no pain on palpation or rebound tenderness, ascote testing for shifting dullness reveals positive results of fluid shift.

Artificial extracorporeal liver support Bioartificial liver devices Liver dialysis Pagacentese Liver biopsy Liver transplantation Portal hypertension Transjugular intrahepatic portosystemic shunt [TIPS] Distal splenorenal shunt procedure.

Please review our privacy policy. But, available data is controversial, and there is no predictive factor to identify patients that respond to diuretic treatment.

Medical management Decision making on the management of ascites depends on the severity of symptoms and not the presence of ascites in and of paracentede.