TREATMENT OPTIONS FOR CIRRHOTIC ASCITES

Ascites due to cirrhosis can usually be managed successfully by dietar y sodium restriction and carefully monitored diuretic therapy. However , paracentesis with an albumin infusion is a relatively safe alternati ve that has gained widespread acceptance. Other plasma expanders offer a cheaper alternative to albumin. Other recently developed techniques include peritoneovenous shunt and transjugular intrahepatic portosyst emic stent shunt. Each of these is associated with an operative mortal ity and substantial complications, but for diuretic-resistant ascites a peritoneovenous shunt has comparable results to paracentesis/albumin . For patients with spontaneously occurring renal failure the prognosi s is poor. None of the above treatments improves renal function. Manag ement should therefore be symptomatic with paracentesis as necessary.