MANAGEMENT OF ADULT PATIENTS WITH ASCITES CAUSED BY CIRRHOSIS

Ascites is the most common of the major complications of cirrhosis. Th e development of ascites is an important landmark in the natural histo ry of cirrhosis and has been proposed as an indication for liver trans plantation. The initial evaluation of a patient with ascites should in clude a history, physical evaluation, and abdominal paracentesis with ascitic fluid analysis. Treatment should consist of abstinence from al cohol, sodium restricted diet, and diuretics. This regimen is effectiv e in approximate to 90% of patients. The treatment options for the diu retic-resistant patients include serial therapeutic paracenteses, live r transplantation, and peritoneovenous shunting.