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3.3.3 - Ascites
from Section 3.3 - Acute Liver Failure
- By Michael Spiro, Jeremy Fabes
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 164-167
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Summary

Key Learning Points
1. The most common cause of ascites in the UK is hepatic cirrhosis.
2. Diagnosis of the underlying aetiology is key for management and dependent on a robust history and examination, with appropriate tests on serum and paracentesis samples.
3. Whilst certain routine tests should be performed on all paracentesis samples, more specialist tests should be ordered, dependent on clinical findings.
4. Clinical suspicion of spontaneous bacterial peritonitis requires rapid diagnosis and management to prevent deterioration.
5. Ascites secondary to portal hypertension that is resistant to medical therapy is an indication for liver transplantation.