This is defined as a pathologic collection of fluid within the abdominal cavity. In the United States, the most common cause is cirrhosis which accounts for approximately 80% of cases. Other causes include congestive heart failure, malignancy, nephrotic syndrome, infection, fulminant hepatitis and alcoholic hepatitis.
Symptoms include abdominal distension and weight gain and the diagnosis is confirmed by ultrasound or CT scan. Treatment involves treating the underlying cause of the ascites, diuretics and often removal of the peritoneal fluid with a simple procedure called paracentesis. Refractory ascites is defined as ascites that doesn’t respond to any of the above therapies and may require TIPS or liver transplantation if caused by cirrhosis.