Description
Development of ascites is an important landmark in the natural history of cirrhosis with a mortality of 50% within 2 years. Significant advances have nevertheless been made in the management of ascites during the last decade. Abdominal paracentesis with ascitic fluid analysis is the most rapid and cost-effective method of diagnosing the cause of ascites. In 90% of patients control of ascites can be achieved with dietary sodium restriction and diuretics. Controlled trials have demonstrated the safety of large volume paracentesis in the treatment of ascites. Transjugular Intrahepatic Portosystemic Shunt (TIPS) and peritoneovenous shunting have a limited role in the management of these patients. Development of refractory ascites should be an indication for transplant assessment.
