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

Link to article at PubMed

Med Clin North Am. 2023 May;107(3):505-516. doi: 10.1016/j.mcna.2022.12.004. Epub 2023 Feb 20.


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.

PMID:37001950 | DOI:10.1016/j.mcna.2022.12.004

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