Ascites

• Autor: Román Vargas, Rossana
• Formato: artículo
• Fecha de Publicación: 2007
• Institución: Colegio Médico del Perú
• Repositorio: Acta Médica Peruana
• Lenguaje: español
• OAI Identifier: oai:ojs.pkp.sfu.ca:article/1233
• Enlace del recurso: https://amp.cmp.org.pe/index.php/AMP/article/view/1233
• Nivel de acceso: acceso abierto
• Materia: Ascites; Peripheral vasodilation; Rennin-angiotensin-aldosteron; Hepatorenal syndrome; Refractory ascites; Paracentesis; Diuretics; spontaneous bacterial peritonitis

Ascites is the abnormal accumulation of fluid into the peritoneal cavity, which in the cirrhotic patient is due to a number of determinant factors. Many theories have been elaborated in that regard during the previous decades, however the current concept states that the chief pathophysiologic mechamism of ascites formation is a permanent state of peripheral vasodilation in the cirrhotic patient, associated with a relative renal hypoperfusion, which in turn activates a host of sodium and water retaining mechanisms. It is a progressive phenomenon and its natural history can be viewed as a spectrum of disease, having at one end of the spectrum the so called hepatorenal syndrome, with ascites refractory to diuretic treatment and a higher frequency of bacterial colonization of the ascitic fluid, so called spontaneous bacterial peritonitis. This article reviews the pathophysiology, diagnosis, complications and therapeutic aspects of ascites in the cirrhotic patient.