Ascites
Overview
Plain-Language Overview
Ascites is a condition where excess fluid builds up in the space between the lining of the abdomen and the organs inside. This fluid accumulation mainly affects the abdominal cavity and can cause the belly to swell and feel heavy or uncomfortable. It often results from problems with the liver, such as scarring or damage, but can also be caused by heart, kidney, or cancer-related issues. The extra fluid can make it harder to breathe and move comfortably. Detecting and understanding the cause of ascites is important because it can signal serious underlying health problems.
Clinical Definition
Ascites is the pathological accumulation of fluid within the peritoneal cavity, most commonly due to portal hypertension secondary to cirrhosis of the liver. The mechanism involves increased hydrostatic pressure in the portal venous system and decreased oncotic pressure from hypoalbuminemia, leading to fluid transudation. Other causes include malignancy, heart failure, and peritoneal infections. Clinically, ascites presents with abdominal distension, shifting dullness on exam, and can lead to complications such as spontaneous bacterial peritonitis. It is a significant marker of advanced liver disease and impacts prognosis and management strategies.