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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
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]
Liver cirrhosis makes it hard for blood to flow in the portal venous system. [39] This resistance creates a backup of blood and increases pressure. [39] This results in portal hypertension. Effects of portal hypertension include: Ascites is a build-up of fluid in the peritoneal cavity in the abdomen [40] An enlarged spleen in 35–50% of cases [6]
After making a differential diagnosis of abdominal distension, it is important to take a careful medical history. [9] Here are the most common causes of abdominal distension classified as an underlying cause and as a secondary disease. As an underlying disease cause: Constipation; Lactose intolerance and other food intolerances
Thus, in people with advanced liver disease the shunting of portal blood away from hepatocytes is usually well tolerated. However, in some cases suddenly shunting portal blood flow away from the liver may result in acute liver failure secondary to hepatic ischemia. [6] Acute hepatic dysfunction after TIPS may require emergent closure of the shunt.
Treatment of NAFLD is generally by dietary changes and exercise to bring about weight loss. [1] In those who are severely affected, liver transplantation may be an option. [ 1 ] More than 90% of heavy drinkers develop fatty liver while about 25% develop the more severe alcoholic hepatitis . [ 4 ]
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]
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]