Chapter 13 - Ascites and Spontaneous Bacterial Peritonitis

Abstract

Ascites is the pathologic accumulation of fluid in the peritoneal cavity, and the most common cause is portal hypertension related to cirrhosis. Ascites is found in up to 60% of patients at the time of the diagnosis of cirrhosis and is associated with increased morbidity and mortality. The complications of ascites include spontaneous bacterial peritonitis, refractory ascites, hyponatremia, and hepatorenal syndrome, which can further lead to worsened survival. The timely recognition and management of ascites can have important prognostic implications. This chapter focuses on the pathophysiology, differential diagnosis, and management of ascites. The management of spontaneous bacterial peritonitis and refractory ascites are also discussed.