Ascitis

Abstract

Ascites is the most common complication in patients with hepatic cirrhosis and portal hypertension and is usually the first manifestation of the disease in most cases. The development of ascites in these patients is the result of a significant impairment in systemic and splanchnic haemodynamics and in renal function. Given that the structural hepatic abnormalities are typically irreversible, most patients with cirrhosis develop repeated episodes of ascites during the course of the disease, which can occasionally be persistent or difficult to control despite continuous treatment. The development of ascites in cirrhosis is a sign of a poor prognosis. The probability of survival 1 and 5 years after the first episode of ascites is 50% and 20%, respectively. This short survival needs to be considered when analysing these patients’ treatment, especially regarding the indication for liver transplantation as the definitive and curative treatment.