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Ascitic fluid can accumulate as a transudate or an exudate. Amounts of up to 35 liters are possible. Roughly, transudates are a result of increased pressure in the hepatic portal vein (>8 mmHg, usually around 20 mmHg [18] (e.g., due to cirrhosis), while exudates are actively secreted fluid due to inflammation or malignancy.
Pleural fluid causes symptoms far more easily than ascitic fluid, due to the lower volume of the pleural cavity as compared to the abdominal cavity. The main symptoms are usually related to the symptoms of liver cirrhosis and ascites. [4] Less often, it may be the only manifestation of chronic liver disease.
The presence of bright red blood in stool, known as hematochezia, typically indicates lower gastrointestinal bleeding. Digested blood from the upper gastrointestinal tract may appear black rather than red, resulting in "coffee ground" vomit or melena. [2] Other signs and symptoms include feeling tired, dizziness, and pale skin color. [18]
Steatorrhea or presence of undigested fats in stool is also a symptom of cirrhosis. [27] Worsening cirrhosis can cause a build-up of fluid in different parts of the body such as the legs and abdomen . [13] Other signs of advancing disease include itchy skin, bruising easily, dark urine, and yellowing of the skin. [13]
The result is called steatorrhea, which is bulky, smelly, and pale-colored stool that often floats in the toilet instead of sinking to the bottom due to its fatty or oily content.
Melena is a form of blood in stool which refers to the dark black, tarry feces that are commonly associated with upper gastrointestinal bleeding. [1] The black color and characteristic strong odor are caused by hemoglobin in the blood being altered by digestive enzymes and intestinal bacteria. [2]
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Congestive hepatopathy, is liver dysfunction due to venous congestion, usually due to congestive heart failure.The gross pathological appearance of a liver affected by chronic passive congestion is "speckled" like a grated nutmeg kernel; the dark spots represent the dilated and congested hepatic venules and small hepatic veins.
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