Cirrhosis and Portal Hypertension: How Do We Deal with Ascites

Med. Clin. North Am. · May 2023

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Cirrhosis and Portal Hypertension: How Do We Deal with Ascites and Its Consequences.

Ascites is the most common complication of cirrhosis, with 5-year mortality reaching 30%. Complications of ascites (ie, spontaneous bacterial peritonitis, hepatorenal syndrome, recurrent/refractory ascites, and hepatic hydrothorax) further worsen survival. ⋯ The treatment of ascites is currently based on the management of fluid overload (eg, diuretics, sodium restriction, and/or paracenteses). In selected patients, long-term albumin use, norfloxacin prophylaxis, and transjugular intrahepatic portosystemic shunt reduce the risk of further decompensation and improve survival.

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- Marta Tonon and Salvatore Piano.
- Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy.
- Med. Clin. North Am. 2023 May 1; 107 (3): 505516505-516.
AbstractAscites is the most common complication of cirrhosis, with 5-year mortality reaching 30%. Complications of ascites (ie, spontaneous bacterial peritonitis, hepatorenal syndrome, recurrent/refractory ascites, and hepatic hydrothorax) further worsen survival. The development of ascites is driven by portal hypertension, systemic inflammation, and splanchnic arterial vasodilation. Etiologic treatment and nonselective beta-blockers can prevent ascites in compensated cirrhosis. The treatment of ascites is currently based on the management of fluid overload (eg, diuretics, sodium restriction, and/or paracenteses). In selected patients, long-term albumin use, norfloxacin prophylaxis, and transjugular intrahepatic portosystemic shunt reduce the risk of further decompensation and improve survival.Copyright © 2022 Elsevier Inc. All rights reserved.

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Cirrhosis and Portal Hypertension: How Do We Deal with Ascites and Its Consequences.

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