How do you approach a patient with ascites?
First line therapy for patients with refractory ascites is serial large-volume paracentesis (LVP), adding albumin if more than 5 L are removed at once. Hepatic hydrothorax should be treated in the same way as cirrhotic ascites, that is, the mainstay of therapy is sodium restriction and diuretics.
How do you read Saag?
A high SAAG (>1.1g/dL) suggests the ascitic fluid is a transudate. A low SAAG (<1.1g/dL) suggests the ascitic fluid is an exudate….Causes of a low SAAG (i.e. exudate) include:
- Malignancy.
- Infection.
- Pancreatitis.
- Nephrotic syndrome.
What is the best test for ascites?
SAAG: The SAAG is the best single test for classifying ascites into portal hypertensive (SAAG >1.1 g/dL) and non–portal hypertensive (SAAG < 1.1 g/dL) causes. Calculated by subtracting the ascitic fluid albumin value from the serum albumin value, it correlates directly with portal pressure.
What is present in a patient with ascites?
Ascites is a buildup of fluid in your abdomen. It often occurs as a result of cirrhosis, a liver disease. Talk to your healthcare provider if you have cirrhosis and notice you’re gaining weight very quickly. Your provider will talk to you about treatments, which often include a low-salt diet.
Which 2 mechanisms contribute to the formation of ascites in liver failure?
The mechanism by which ascites develops in cirrhosis is multifactorial Severe sinusoidal portal hypertension and hepatic insufficiency are the initial factors.
What does SAAG less than 1.1 mean?
In patients with a low SAAG (<1.1 g/dL), the risk of hemodynamic compromise with large‐volume paracentesis (>5 L) is low. Frequently, fluid reaccumulates rapidly, necessitating repeated large‐volume paracenteses for chronic management of the ascites.
What Colour is ascites fluid?
Ascitic fluid is typically translucent and yellow. Fluid of other colour or consistency may reflect specific underlying disease processes (see table).
Does ascites contain blood?
Pink or bloody fluid is most often caused by mild trauma, with subcutaneous blood contaminating the sample. Bloody ascites is also associated with hepatocellular carcinoma or any malignancy-associated ascites….Table 2. Gross Appearance of Ascites Fluid.
| Color | Association |
|---|---|
| Translucent or yellow | Normal/sterile |