This fluid collects in the space within the walls of the abdomen, between the abdominal organs. It is common in patients with liver disease and cirrhosis, though patients with cancer can also develop ascites. Two main reasons cause ascites in patients with cancer. First, cancer can spread to the lining of the organs—the peritoneum—and make it leaky, causing malignant ascites.
Second, cancer can spread to the liver and cause increased pressure in the liver. Certain cancers, such as ovarian, pancreatic, liver, and colon cancers, are more likely to cause ascites.
Patients can experience swelling and tightness of the abdomen, feeling full when eating, nausea, or shortness of breath. The fluid can become infected, which can cause fever and pain. Ascites may be suspected because of symptoms and examination findings. Ultrasonography is often the first step. A computed tomography or magnetic resonance imaging scan can provide more information about the underlying cancer.
A needle and syringe may be used to remove some of the fluid in a procedure called a paracentesis. Checking this fluid for white blood cells, blood, cancer cells, and bacteria can help determine the cause and diagnose an infection, if present.
Finding cancer cells in the fluid confirms a diagnosis of malignant ascites as opposed to liver damage or other causes. Treatment depends on the cause cancer spread or liver damage ; the severity of symptoms; the cancer type, extent of spread, and suitability of anticancer treatments; and patient preferences.
If patients have few symptoms, specific treatment may not be needed. If liver damage is the cause, patients may be prescribed a diuretic water pill to increase water in the urine or asked to cut down the amount of salt in their food. If patients have severe tightness in the abdomen or shortness of breath, a paracentesis can remove several liters of fluid in minutes. A hollow needle is inserted into the fluid and connected to a bottle via tubing. This can provide immediate relief, though fluid can return, often in days to weeks.
The procedure can be repeated if needed. If fluid keeps recurring, an alternative may be to place an indwelling flexible catheter into the fluid cavity that can open to the outside through the skin and be drained using a valve. Patients or caregivers can typically be trained to do this at home. For most patients, development of malignant ascites signals advanced, incurable cancer. Often, there may be no suitable cure for the underlying cancer.
Net www. People may have a fever and feel generally unwell. They may become confused, disoriented, and drowsy. Untreated, this infection can be fatal. Survival depends on early treatment with appropriate antibiotics. When a doctor taps percusses the abdomen, the fluid makes a dull sound. If the person's abdomen is swollen because the intestines are distended with gas, the tapping makes a hollow sound.
However, a doctor may not be able to detect ascitic fluid unless the volume is about a quart or more. If doctors are uncertain whether ascites is present or what is causing it, they may do ultrasonography or computed tomography CT; see Imaging Tests of the Liver and Gallbladder Imaging Tests of the Liver and Gallbladder Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, radionuclide scanning, computed tomography CT , magnetic resonance imaging MRI , endoscopic retrograde cholangiopancreatography In addition, a small sample of ascitic fluid can be withdrawn by inserting a needle through the wall of the abdomen—a procedure called diagnostic paracentesis Paracentesis Paracentesis is the insertion of a needle into the abdominal cavity for the removal of fluid.
Normally, the abdominal cavity contains only a small amount of fluid. However, fluid can accumulate Laboratory analysis of the fluid can help determine the cause. The basic treatment for ascites is a low-sodium diet with a goal of 2, mg or less of sodium per day.
If diet is ineffective, people are usually also given drugs called diuretics such as spironolactone or furosemide. Diuretics make the kidneys excrete more sodium and water into the urine so people urinate more.
If ascites becomes uncomfortable or makes breathing or eating difficult, the fluid may be removed through a needle inserted into the abdomen—a procedure called therapeutic paracentesis. The fluid tends to reaccumulate unless people also follow a low-sodium diet and take a diuretic. Because a large amount of albumin is usually lost from the blood into the abdominal fluid, albumin may be given intravenously. If large amounts of fluid accumulate frequently or if other treatments are ineffective, a portosystemic shunt or liver transplantation Liver Transplantation Liver transplantation is the surgical removal of a healthy liver or sometimes a part of a liver from a living person and then its transfer into a person whose liver no longer functions.
The portosystemic shunt Portosystemic shunting Portal hypertension is abnormally high blood pressure in the portal vein the large vein that brings blood from the intestine to the liver and its branches.
However, placement of the shunt is an invasive procedure and can cause problems, such as deterioration of brain function hepatic encephalopathy Hepatic Encephalopathy Hepatic encephalopathy is deterioration of brain function that occurs in people with severe liver disease because toxic substances normally removed by the liver build up in the blood and reach If spontaneous bacterial peritonitis is diagnosed, people are given antibiotics such as cefotaxime.
Because this infection often recurs within a year, a different antibiotic such as norfloxacin is given after the initial infection resolves to prevent the infection from recurring. Merck and Co. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.
The Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge. This can be very uncomfortable.
The fluid causes swelling that can make the tummy feel tight and very uncomfortable. It often develops over a few weeks but might happen over a few days. Your doctor puts a needle into your abdomen to take a sample of fluid. They use an ultrasound scan to guide them. They use a syringe to draw out some fluid to send to the laboratory. In the lab, they examine it under a microscope to look for cancer cells. You might need some care and support at home.
A lot of practical and emotional support is available to you. About Cancer generously supported by Dangoor Education since Questions about cancer?
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