Ascites are a relatively frequent complication of various diseases of internal organs. In this case, fluid in the abdominal cavity can be transudative and exudative. In the first case, it accumulates due to circulatory disorders and lymph flow, in the second - contains a large number of leukocytes and protein compounds due to the development of acute inflammatory processes.
Causes of fluid accumulation in the abdominal cavity
About 80% of all ascites are the consequences of progressive liver cirrhosis. In the late stages of this disease there is a severe disturbance of blood flow, stagnation of the biological fluid.
In 10% of cases, fluid in the abdominal cavity is diagnosed in oncology. As a rule, ascites accompanies ovarian cancer and is considered a very menacing symptom. Filling the space between the digestive organs with lymph or effusion usually indicates a severe course of the disease and the proximity of the lethal outcome. Also, the problem is a sign of such tumors:
- primary mesothelioma;
- lymphoma;
- secondary carcinomatosis;
- metastases in the gates of the liver;
- leukemia;
- pseudomixoma;
- carcinomatosis.
Approximately 5% of ascites are symptoms of cardiovascular pathologies:
- decompensation of blood circulation;
- heart defects;
- constrictive pericarditis;
- chronic ailments.
A concomitant sign of these diseases is a strong swelling of the face and limbs.
With the remaining 5% of diagnoses, free fluid in the abdominal cavity is formed after surgery, against the background of:
- pancreatitis;
- diabetes mellitus;
- renal failure, systemic lupus erythematosus;
- portal hypertension;
- the Meigs syndrome;
- vein-occlusive disease;
- peritonitis of various origin;
- Badda-Chiari disease;
- pancreatic cysts ;
- Whipple's syndrome and other pathological conditions.
Determination of the presence of fluid in the abdominal cavity by ultrasound
It is impossible to detect ascites independently, especially at the beginning of water accumulation. There are several characteristic signs of the problem, for example:
- heaviness in the abdomen ;
- violations of defecation;
- dull or drawing pain in the intestine;
- changes in the frequency of urination and the volume of bioavailable;
- eructation;
- sometimes - difficulty breathing;
- swelling of the limbs, face;
- "Frog" belly.
But the listed symptoms are peculiar to many diseases, therefore it is difficult to connect them with the accumulation of fluid in the abdominal space. The only reliable method for diagnosing ascites is ultrasound. During the procedure it is clearly visible not only the presence of trans- or exudate, but also its volume, which in some cases can reach 20 liters.
Therapy and pumping of fluid from the abdominal cavity
Refractory, "large" and "giant" ascites should be treated surgically, since large volumes of fluid can not be withdrawn by conservative methods.
Laparocentesis is a procedure for piercing the stomach with a trocar, a special device consisting of a needle and a thin tube attached to it. The event is performed under the supervision of ultrasound and local anesthesia. For 1 session, no more than 6 liters of liquid is output, and slowly. Accelerated pumping out of ex- or transudate can lead to a sharp drop in blood pressure and
To compensate for protein and mineral salt losses, a solution of albumin, polyglucin, aminostearyl, hemaccel, and other similar drugs is simultaneously administered.
In modern surgery, a permanent peritoneal catheter is also practiced. With its help, the liquid is removed continuously, but very slowly.
Conservative treatment of ascites is effective in the light and medium stages of pathology. It is appointed only by a specialist after finding out the causes of the problem.