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Ascites (/ ə ˈ s aɪ t i z /; [5] Greek: ἀσκός, romanized: askos, meaning "bag" or "sac" [6]) is the abnormal build-up of fluid in the abdomen. [1] Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. [4]
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
Response to treatment generally requires 1 to 3 months in the case of acne and up to 6 months in the case of hirsutism. [67] Ongoing therapy is generally required to avoid relapse of symptoms. [67] Spironolactone is commonly used in the treatment of hirsutism in women, and is considered to be a first-line antiandrogen for this indication. [68]
Women make testosterone from their ovaries, which is then converted to estrogen, Dorr explains. This helps kick off the menstrual cycle and leads to the growth of underarm and pubic hair.
The rectouterine pouch, being the lowest part of the peritoneal cavity in a woman at supine position, is a common site for the spread of pathology such as ascites, tumour, endometriosis, pus, etc. As it is the furthest point of the abdominopelvic cavity in women, it is a site where infection and fluids typically collect. [5]
Pseudomyxoma peritonei (PMP) is a clinical condition caused by cancerous cells (mucinous adenocarcinoma) that produce abundant mucin or gelatinous ascites. [1] The tumors cause fibrosis of tissues and impede digestion or organ function, and if left untreated, the tumors and mucin they produce will fill the abdominal cavity.
The 2012 clinical practice guidelines by the American Association for the Study of Liver Diseases (AASLD) states that amiloride can be used to treat ascites in place of spironolactone if it isn't tolerated (e.g. due to the side effect of gynecomastia), though amiloride isn't a preferred drug due to cost and lack of efficacy. [14]
The serum-ascites albumin gradient or gap (SAAG) is a calculation used in medicine to help determine the cause of ascites. [1] The SAAG may be a better discriminant than the older method of classifying ascites fluid as a transudate versus exudate. [2] The formula is as follows: SAAG = (serum albumin) − (albumin level of ascitic fluid).