Prise en charge symptomatique de l’ascite maligne en phase palliative: place de la paracentèse et des diurétiques. Supportive care for malignant ascites in. Chez dix patients cirrhotiques porteurs d’une ascite sous tension, la pression voie endoscopique au moyen d’une fine aiguille, avant et après paracentèse. Mr G. presented for acute care 3 weeks ago with tense ascites, which was managed with a large volume paracentesis (LVP) of approximately 4 L. He was.

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The patient is usually discharged within several hours following post-procedure observation provided that blood pressure is otherwise normal and the patient experiences no dizziness. Top of the page – Article Outline. The procedure is often performed in a doctor’s office or an outpatient clinic. Ascites is defined as the presence of excessive fluid in the peritoneal cavity. Transjugular intrahepatic portosystemic shunt A TIPS is a shunt between the portal vein and the hepatic vein, designed to reduce portal hypertension and improve renal sodium excretion by directly bypassing the cirrhotic parenchymal tissue.

He is no longer able to swallow his medications including his diuretics. The ascitic white blood cell count can help determine if the ascites is infected.

Ascites in patients with cirrhosis

Author information Copyright and License information Disclaimer. He also has moderate bilateral peripheral edema. Natural history and prognostic indicators of survival in cirrhosis: Additional evidences are required before guidelines can be established for the palliative management of malignant ascites. Colonoscopy Anoscopy Capsule endoscopy Enteroscopy Proctoscopy Sigmoidoscopy Abdominal ultrasonography Defecography Double-contrast barium enema Endoanal ultrasound Enteroclysis Lower gastrointestinal series Small-bowel follow-through Transrectal ultrasonography Virtual colonoscopy.


First-line therapy includes sodium restriction. In most cases, ascites is due to peritoneal carcinomatosis in which vascular permeability is enhanced by VEGF production while lymphatic drainage decreases. Management of patients with ascites in end-stage cirrhosis is becoming more common in palliative care.

Tunneled catheters are preferred over pigtail catheters owing to stability and lower rates of infection. Epub Sep 4. Permanent catheters can be under continuous or intermittent drainage, with the frequency determined by the patient in accordance with symptom control. Esophagogastroduodenoscopy Barium swallow Upper gastrointestinal series. Digestive system procedures Abdominal surgical procedures Veterinary diagnosis. J Vasc Interv Radiol.

Prospective evaluation of the Acite catheter when used to treat recurrent ascites associated with malignancy. He is married and has 3 adult children.

In an expert’s hands it is usually very safe, although there is a small risk of infection, excessive bleeding or perforating a loop of bowel.

His overall appetite has declined, and this is distressing to his family. Sodium restriction First-line therapy includes sodium restriction. If you want to subscribe to this journal, see our rates You can purchase this item paracentesw Pay Per View: Int J Clin Oncol.



The indication of diuretic treatment is left to the appreciation of physicians. This page was last edited on 9 Novemberat Outline Masquer le plan.

Once ascitic fluid is mobilized and symptom control is achieved, the dosage of diuretics needs to be reconsidered with the goal of maintaining symptom control with paraentese lowest dose of diuretics possible in order to prevent diuretic-induced side effects.

If more rapid symptom control is required, or if the patient has recurrent ascites, then starting combination therapy from the onset should be considered.

Management qscite refractory ascites Refractory ascites occurs in patients who do not respond to diuretic therapy, who have diuretic-induced complications, or for whom ascites recurs rapidly after therapeutic paracentesis.

The procedure is used to remove fluid from the peritoneal cavity, particularly if this cannot pxracentese achieved with medication. Epub Jun 1. Within 7 days, Mr G. Please review our privacy policy.