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Ascites
Ascites (; , meaning "bag" or "sac") is the abnormal build-up of fluid in the abdomen. Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath. Complications can include spontaneous bacterial peritonitis. In the developed world, the most common cause is liver cirrhosis. Other causes include cancer, heart failure, tuberculosis, pancreatitis, and blockage of the hepatic vein. In cirrhosis, the underlying mechanism involves high blood pressure in the portal system and dysfunction of blood vessels. Diagnosis is typically based on an examination together with ultrasound or a CT scan. Testing the fluid can help in determining the underlying cause. Treatment often involves a low-salt diet, medication such as diuretics, and draining the fluid. A transjugular intrahepatic portosystemic shunt (TIPS) may be ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Hepatorenal Syndrome
Hepatorenal syndrome (HRS) is a life-threatening medical condition that consists of acute kidney failure, rapid deterioration in kidney function in individuals with cirrhosis or fulminant liver failure. HRS is usually fatal unless a liver transplantation, liver transplant is performed, although various treatments, such as Kidney dialysis, dialysis, can prevent advancement of the condition. HRS can affect individuals with cirrhosis, severe alcoholic hepatitis, or liver failure, and usually occurs when liver function deteriorates rapidly because of a sudden insult such as an infection, upper gastrointestinal hemorrhage, bleeding in the gastrointestinal tract, or overuse of diuretic medications. HRS is a relatively common complication of cirrhosis, occurring in 18% of people within one year of their diagnosis, and in 39% within five years of their diagnosis. Deteriorating liver function is believed to cause changes in the splanchnic circulation, circulation that supplies the intest ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Liver Cirrhosis
Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, chronic liver failure or chronic hepatic failure and end-stage liver disease, is a chronic condition of the liver in which the normal functioning tissue, or parenchyma, is replaced with scar tissue ( fibrosis) and regenerative nodules as a result of chronic liver disease. Damage to the liver leads to repair of liver tissue and subsequent formation of scar tissue. Over time, scar tissue and nodules of regenerating hepatocytes can replace the parenchyma, causing increased resistance to blood flow in the liver's capillaries—the hepatic sinusoids—and consequently portal hypertension, as well as impairment in other aspects of liver function. The disease typically develops slowly over months or years. Stages include compensated cirrhosis and decompensated cirrhosis. Early symptoms may include tiredness, weakness, loss of appetite, unexplained weight loss, nausea and vomiting, and discomfort in the right upper ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Paracentesis
Paracentesis (from Ancient Greek, Greek κεντάω, "to pierce") is a form of body fluid sampling procedure, generally referring to peritoneocentesis (also called laparocentesis or abdominal paracentesis) in which the peritoneal cavity is punctured by a needle to sample peritoneal fluid. The procedure is used to remove fluid from the peritoneal cavity, particularly if this cannot be achieved with medication. The most common indication is ascites that has developed in people with cirrhosis. Indications It is used for a number of reasons: * to relieve abdominal pressure from ascites * to diagnose spontaneous bacterial peritonitis and other infections (e.g. abdominal TB) * to diagnose metastatic cancer * to diagnose blood in peritoneal space in trauma Paracentesis for ascites The procedure is often performed in a doctor's office or an outpatient clinic. In an expert's hands, it is usually very safe, although there is a small risk of infection, excessive bleeding or perforating ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Budd–Chiari Syndrome
Budd–Chiari syndrome is a condition when an occlusion or obstruction in the hepatic veins prevent normal outflow of blood from the liver. The symptoms are non-specific and vary widely, but it may present with the classical triad of abdominal pain, ascites, and liver enlargement. Untreated Budd-Chiari syndrome can result in liver failure. It is usually seen in younger adults, with the median age at diagnosis between 35 and 40 years, and it has a similar incidence in males and females. It is a very rare condition, affecting one in a million adults. The syndrome can be fulminant, acute, chronic, or asymptomatic. Subacute presentation is the most common form. Patients with hypercoagulable disorders, polycythemia vera, and hepatocellular carcinoma are at a higher risk of having Budd-Chiari syndrome. Signs and symptoms The acute syndrome presents with rapidly progressive and severe upper abdominal pain, yellow discoloration of the skin and whites of the eyes, liver e ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Spontaneous Bacterial Peritonitis
Spontaneous bacterial peritonitis (SBP) is the development of a bacterial infection in the peritoneum, despite the absence of an obvious source for the infection. It is specifically an infection of the ascitic fluid – an increased volume of peritoneal fluid. Ascites is most commonly a complication of cirrhosis of the liver. It can also occur in patients with nephrotic syndrome. SBP has a high mortality rate. The diagnosis of SBP requires paracentesis, a sampling of the peritoneal fluid taken from the peritoneal cavity. If the fluid contains large numbers of white blood cells known as neutrophils (>250 cells/μL), infection is confirmed and antibiotics will be given, without waiting for culture results. In addition to antibiotics, infusions of albumin are usually administered. Other life-threatening complications such as kidney malfunction and increased liver insufficiency can be triggered by spontaneous bacterial peritonitis. 30% of SBP patients develop kidney malfunct ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Portal Hypertension
Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. The portal vein and its branches supply most of the blood and nutrients from the intestine to the liver. Cirrhosis (a form of chronic liver failure) is the most common cause of portal hypertension; other, less frequent causes are therefore grouped as non-cirrhotic portal hypertension. The signs and symptoms of both cirrhotic and non-cirrhotic portal hypertension are often similar depending on cause, with patients presenting with abdominal swelling due to ascites, vomiting of blood, and lab abnormalities such as elevated liver enzymes or low platelet counts. Treatment is directed towards decreasing portal hypertension itself or in ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Heart Failure
Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to Cardiac cycle, fill with and pump blood. Although symptoms vary based on which side of the heart is affected, HF typically presents with shortness of breath, Fatigue (medical), excessive fatigue, and bilateral peripheral edema, leg swelling. The severity of the heart failure is mainly decided based on ejection fraction and also measured by the severity of symptoms. Other conditions that have symptoms similar to heart failure include obesity, kidney failure, liver disease, anemia, and thyroid disease. Common causes of heart failure include coronary artery disease, heart attack, hypertension, high blood pressure, atrial fibrillation, valvular heart disease, alcohol use disorder, excessive alcohol consumption, infection, and cardiomyopathy. These cause heart failure by altering the structure or the function of the heart or in some cases both. There are ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Transjugular Intrahepatic Portosystemic Shunt
Transjugular intrahepatic portosystemic shunt (TIPS or TIPSS) is an artificial channel within the liver that establishes communication between the inflow portal vein and the outflow hepatic vein. It is used to treat portal hypertension (which is often due to liver cirrhosis) which frequently leads to intestinal bleeding, life-threatening esophageal bleeding ( esophageal varices) and the buildup of fluid within the abdomen ( ascites). An interventional radiologist creates the shunt using an image-guided endovascular (via the blood vessels) approach, with the jugular vein as the usual entry site. History The procedure was first described by Josef Rösch in 1969 while working as a research fellow with Charles Dotter, the "Father of Interventional Radiology," at Oregon Health and Science University. Dr. Rösch became a visiting professor at the University of California, Los Angeles, where he made an accidental entry into the peripheral portal venous branch while attempting ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Spironolactone
Spironolactone, sold under the brand name Aldactone among others, is classed as a diuretic medication. It can be used to treat edema, fluid build-up due to hepatic cirrhosis, liver disease or kidney disease. It is also used to reduce risk of disease progression, hospitalization and death due to some types of heart failure. Other uses include acne and excessive hair growth in women, hypokalemia, low blood potassium that does not improve with Potassium#Supplementation, supplementation, high blood pressure that is difficult to treat and early puberty in boys. It can also be used to block the effects of testosterone in transgender women and Non-binary gender, nonbinary people undergoing Feminizing hormone therapy, feminizing hormone replacement therapy. Spironolactone is usually available in tablets, taken oral administration, by mouth, though topical forms are also available. Common side effects include electrolyte abnormalities, particularly hyperkalemia, high blood potassium ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
