The abdomen has a large space (called the periotoneal cavity) that can sometimes become filled with fluid, resulting in a condition known as ascites. Ascites are typically a sign of a more serious underlying medical disorder, such as liver or kidney problems. The fluid accumulation can itself be treated, but the underlying cause should also be identified and addressed.
Ascites and Cirrhosis
Abdominal ascites, according to Medline, is most commonly caused by liver damage. Damage to the liver can lead to blockage of the portal vein, which shuttles blood to the liver for processing. When the portal vein becomes obstructed, it can cause fluid to back up into the abdominal cavity, resulting in abdominal ascites. Liver damage can also cause low levels of a protein called albumin, which helps keep fluid in the blood vessels; low albumin levels also contributes to ascites. Liver damage may be due to an infection, chronic alcohol abuse or other disorders, such as an autoimmune problem.
Other Causes
Although liver failure is the most common cause of ascites, there are other conditions that can lead to fluid accumulation in the abdomen. Pancreatic cancer can cause fluid to build up in the abdominal cavity. Medical problems that cause excess fluid to be retained in the veins can also cause ascites, the "Journal of the American Medical Association" explains. As a result, heart failure and kidney disease are also potential causes of ascites. Certain infections, such as tuberculosis, can also lead to abdominal ascites.
Paracentesis
Treatment of abdominal ascites often hinges on identifying the underlying cause. One way of doing that, according to the "Journal of the American Medical Association," is to perform an abdominal paracentesis. With this procedure a needle is inserted into the abdominal cavity to remove a sample of the fluid, which can then be analyzed. If the cause of the ascites is liver failure, there should be low levels of albumin in the fluid. Other causes can be diagnosed by measuring the type and number of cells present in the fluid. Additional testing (such as liver and kidney function tests as well as an abdominal ultrasound) can be done to confirm the diagnosis.
Non-Invasive Treatment
If possible, the underlying cause of the ascites should be treated, particularly if it is caused by liver cirrhosis. Other treatments, which can be done to reduce the fluid accumulation in the abdomen center on removing excess fluid from the body. Patients may be told to avoid salt and alcohol consumption, as these things can cause the body to retain water. Diuretics can be prescribed to aid in the elimination of water from the body. If the ascites become infected, antibiotics may be necessary.
Severe Ascites
If the ascites are not responding to more conservative modes of treatment, Medline explains that more aggressive treatments may be necessary. A large volume paracentesis can be done to drain the excess fluid. In addition, blood flow can be rerouted around the liver via an operation called a transjugular intrahepatic portosystemic shunt.
