Ascites

Ascites is the accumulation of fluid within the abdominal cavity. There are many malignant and non-malignant causes, but the symptoms are generally the same with progressive abdominal swelling with shifting dullness on examination. There may be secondary symptoms of breathlessness, nausea, vomiting and constipation.

Causes

• Liver disease
• Peritoneal metastases
• Ovarian malignancy
• Hypoalbuminaemia
• Heart failure
• Venous compression or thrombosis of inferior vena cava

Non-drug treatment

• In mild cases explanation and reassurance may be all that is required
• Mainstay is drainage of the fluid by abdominal paracentesis
• Indwelling drainage systems may be considered in recurrent cases

Drug treatments

• Diuretics - may be appropriate in liver or heart disease
• Chemotherapy for malignant causes may be considered
• Analgesia
• Antiemetics
• Laxatives
• Corticosteroids may have a role in compressive causes