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Refractory ascites is characterized as ascites that recurs or does not recede post-paracentesis, despite diet control and diuretic treatment. [14] Uncomplicated ascites is more common, responsive to treatment, and exists in three grades: [15] Grade 1: mild, only visible on ultrasound and CT; Grade 2: detectable with flank bulging and shifting ...
The treatment of hepatic encephalopathy depends on the suspected underlying cause (types A, B, or C) and the presence or absence of underlying causes. If encephalopathy develops in acute liver failure (type A), even in a mild form (grade 1–2), it indicates that a liver transplant may be required, and transfer to a specialist centre is advised ...
Abdominal distension occurs when substances, such as air (gas) or fluid, accumulate in the abdomen causing its expansion. [1] It is typically a symptom of an underlying disease or dysfunction in the body, rather than an illness in its own right.
Budd–Chiari syndrome is a condition when an occlusion or obstruction in the hepatic veins prevent normal outflow of blood from the liver.. The symptoms are non-specific and vary widely, but it may present with the classical triad of abdominal pain, ascites, and liver enlargement.
The serum-ascites albumin gradient (SAAG) is the most useful index for evaluating peritoneal fluid and can help distinguish ascites caused by portal hypertension (cirrhosis, portal vein thrombosis, Budd-Chiari syndrome, etc.) from other causes of ascites. SAAG is calculated by subtracting the albumin measure of ascitic fluid from the serum value.
For these individuals, the first treatment of choice is the insertion of a transjugular intrahepatic portosystemic shunt. The only curative treatment is a liver transplant. Additionally, treatment involves addressing the underlying cause of the liver disease, such as alcohol use or viral hepatitis. [6] Treatment flowchart for hepatic hydrothorax
It has been hypothesized that the progression from ascites to hepatorenal syndrome is a spectrum where splanchnic vasodilation defines both resistance to diuretic medications in ascites (which is commonly seen in type 2 HRS) and the onset of kidney vasoconstriction (as described above) leading to hepatorenal syndrome. [8]
Alcoholic hepatitis is characterized by a number of symptoms, which may include feeling unwell, enlargement of the liver, development of fluid in the abdomen (ascites), and modest elevation of liver enzyme levels (as determined by liver function tests). [4]