Ascites

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 mechami...

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Detalhes bibliográficos
Autor: Román Vargas, Rossana
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2007
País:Perú
Recursos:Colegio Médico del Perú
Repositorio:Acta Médica Peruana
Idioma:español
OAI Identifier:oai:amp.cmp.org.pe:article/1233
Acesso em linha:https://amp.cmp.org.pe/index.php/AMP/article/view/1233
Access Level:acceso abierto
Palavra-chave:Ascitis
Vasodilatación periférica
Renina-angiotensinaaldosterona
Síndrome hepato-renal
Ascitis refractaria
Paracentesis
Diuréticos
Peritonitis bacteriana espontánea
Ascites
Peripheral vasodilation
Rennin-angiotensin-aldosteron
Hepatorenal syndrome
Refractory ascites
Diuretics
spontaneous bacterial peritonitis
Descrição
Resumo: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.