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Acta Médica Peruana

On-line version ISSN 1728-5917


ROMAN VARGAS, Rossana. Ascites. Acta méd. peruana [online]. 2007, vol.24, n.1, pp.34-39. ISSN 1728-5917.

Ascites is the abnormal accumulation of fluid into the peritoneal cavity, which in the cirrhotic patient is due to a number of determinant factors. Many theories have been elaborated in that regard during the previous decades, however the current concept states that the chief pathophysiologic mechamism of ascites formation is a permanent state of peripheral vasodilation in the cirrhotic patient, associated with a relative renal hypoperfusion, which in turn activates a host of sodium and water retaining mechanisms. It is a progressive phenomenon and its natural history can be viewed as a spectrum of disease, having at one end of the spectrum the so called hepatorenal syndrome, with ascites refractory to diuretic treatment and a higher frequency of bacterial colonization of the ascitic fluid, so called spontaneous bacterial peritonitis. This article reviews the pathophysiology, diagnosis, complications and therapeutic aspects of ascites in the cirrhotic patient.

Keywords : ascites; peripheral vasodilation; rennin-angiotensin-aldosteron; hepatorenal syndrome; refractory ascites; paracentesis; diuretics; spontaneous bacterial peritonitis.

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