In medicine (gastroenterology), ascites (also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more archaically as abdominal dropsy) is an accumulation of fluid in the peritoneal cavity. Although most commonly due to cirrhosis and severe liver disease, its presence can portend other significant medical problems.
Diagnosis of the cause is usually with blood tests, an ultrasound scan of the abdomen and direct removal of the fluid by needle or paracentesis (which may also be therapeutic). Treatment may be with medication (diuretics), paracentesis or other treatments directed at the cause.
Signs and symptoms
Mild ascites is hard to notice, but severe ascites leads to abdominal distension. Patients with ascites generally will complain of progressive abdominal heaviness and pressure as well as shortness of breath due to mechanical impingement on the diaphragm.
Ascites is detected on physical examination of the abdomen by visible bulging of the flanks in the reclining patient ("flank bulging"), " shifting dullness " (difference in percussion note in the flanks that shifts when the patient is turned on the side) or in massive ascites with a "fluid thrill" or "fluid wave " (tapping or pushing on one side will generate a wave-like effect through the fluid that can be felt in the opposite side of the abdomen).
Other signs of ascites may be present due to its underlying etiology. For instance, in portal hypertension (perhaps due to cirrhosis or fibrosis of the liver) patients may also complain of leg swelling, bruising, gynecomastia, hematemesis, or mental changes due to encephalopathy. Those with ascites due to cancer (peritoneal carcinomatosis) may complain of chronic fatigue or weight loss. Those with ascites due to heart failure may also complain of shortness of breath as well as wheezing and exercise intolerance.
Classification
Ascites exists in three grades:
- Grade 1: mild, only visible on ultrasound
- Grade 2: detectable with flank bulging and shifting dullness
- Grade 3: directly visible, confirmed with fluid thrill
Remedies & Symptoms
ANTHRACINUM
- Inturation of cellular tissue.
- Red lines, streaks and stripes mark out the course of the lymphatics.
- Oedema of the affected parts.
- Discharge of ichorous, foul- smelling pus.
- Gangrene, absorption of ichor with ichoraemia collapse.
- Violent burning pains, not relieved by Arsenic.
- If given early will sometimes about anthrax, later it promotes suppuration.
- Carbuncle surrounded by anthrax, later it promotes suppuration.
- Carbuncle surrounded by indurated spots, pain intense, sleeplessness.
- Stinging burning of edges of ulcer with corroding discharge.
RHUS TOX
- The parts shaves a blush gangrenous appearance.
- Itching, burning around the carbuncle, with vertigo, stupor, pale face.
- Great restlessness; patient feels better while moving about.
- More indicated in the beginning, when the pains are intense and the affected parts are dark red.
TARENTULA CUBANA
- Anthrax,, especially on back of neck, with burning excruciating pain.
- Eeysipelatous redness around the carbuncle.
- Rigors followed by burning fever, great thirst anxiety, headache, delirium.
- Profuse perspiration and retention of urine, intense pains in carbuncle.