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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.
Other signs of ascites may be present due to its underlying cause. For instance, in portal hypertension (perhaps due to cirrhosis or fibrosis of the liver) people may also complain of leg swelling, bruising, gynecomastia, hematemesis, or mental changes due to encephalopathy. Those with ascites due to cancer (peritoneal carcinomatosis) may ...
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.
Ascites is most commonly a complication of cirrhosis of the liver. [1] It can also occur in patients with nephrotic syndrome. [3] [4] SBP has a high mortality rate. [5] The diagnosis of SBP requires paracentesis, a sampling of the peritoneal fluid taken from the peritoneal cavity. [6]
Portal hypertension due to cirrhosis resulting in revascularization of the umbilical vein Ultrasonography (US) is the first-line imaging technique for the diagnosis and follow-up of portal hypertension because it is non-invasive, low-cost and can be performed on-site.
This is used in the treatment of refractory ascites, bleeding from esophageal varices and hepatorenal syndrome. [12] [13] TIPS-related encephalopathy occurs in about 30% of cases, with the risk being higher in those with previous episodes of encephalopathy, higher age, female sex, and liver disease due to causes other than alcohol. [10]
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