Liver and intrahepatic bile ducts-nontumor
Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 20 October 2014, last major update April 2012
Copyright: (c) 2004-2014, PathologyOutlines.com, Inc.
● Excess fluid in peritoneal cavity; usually detectable when 500 ml; usually serous, < 3 g/dl of protein
● Presence of neutrophils suggests secondary infection, red blood cells suggests disseminated intraabdominal cancer, hydrothorax suggests long standing process with seepage through transdiaphragmatic lymphatics
● Causes: sinusoidal hypertension drives fluid into space of Disse, normally removed by hepatic lymphatics
● Ascites is promoted by hypoalbuminemia, cirrhosis, portal hypertension
Severe ascites due to cirrhosis
● Treat underlying disorder; diuretics and salt restriction; if necessary, peritoneal dialysis or hemodialysis (Nefrologia 2011;31:648)
● Liver transplantation for refractory ascites, which otherwise has poor prognosis (World J Gastroenterol 2009;15:67)
● Ascites fluid cytology is almost always negative in patients with cirrhosis, even those known or suspected to have hepatocellular carcinoma (Cytojournal 2009 Aug 7;6:16)
Ascites fluid cytology
Various images in patients with ascites, all interpreted as negative
● Baillieres Clin Gastroenterol 1997;11:365, Best Pract Res Clin Endocrinol Metab 2003;17:607
End of Liver and intrahepatic bile ducts-nontumor > General concepts > Ascites
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