Cirrhosis and Portal Hypertension: How Do We Deal with Ascites and Its Consequences.

Marta Tonon, Salvatore Piano

Journal: The Medical clinics of North America 2023;107(3):505-516

PMID: 37001950

Full Text on Elsevier Science View on PubMed

Abstract

Ascites is the most common complication of cirrhosis, with 5-year mortality reaching 30%. Complications of ascites (ie, spontaneous bacterial peritonitis, hepatorenal syndrome, recurrent/refractory ascites, and hepatic hydrothorax) further worsen survival. The development of ascites is driven by portal hypertension, systemic inflammation, and splanchnic arterial vasodilation. Etiologic treatment and nonselective beta-blockers can prevent ascites in compensated cirrhosis. The treatment of ascites is currently based on the management of fluid overload (eg, diuretics, sodium restriction, and/or paracenteses). In selected patients, long-term albumin use, norfloxacin prophylaxis, and transjugular intrahepatic portosystemic shunt reduce the risk of further decompensation and improve survival.

Address: Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy.; Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy. Electronic address: [email protected].

DOI: 10.1016/j.mcna.2022.12.004

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MeSH Terms: Humans, Ascites, Liver Cirrhosis, Liver Transplantation, Hypertension, Portal