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Hemanth P
Dialysis Tutor
B N Patel Institute of Paramedical Science
• Defined as the accumulation of fluid in peritoneal cavity.
• Etiology:
– Most commonly seen in patients with Portal Hypertension and
Cirrhosis, Intra-abdominal malignancy, CHF, and MT.
• Diagnosis:
– Liver Diseases, Risk factors for Hep C & B, cancer, HF, TB, dialysis and
pancreatitis.
– Operative injury to the ureter or bladder can lead to leakage of urine
in to peritoneal cavity.
Clinical Features
• Asymptomatic Ascites:
– Fluid <100 – 400ml
– Mild Ascites
• Symptomatic Ascites:
– Fluid >400ml
– Increased abdominal girth, presence of abdominal pain or discomfort,
early satiety, pedal edema, wt. gain and respiratory distress.
Physical Examination Findings
• Umbilicus eversion
• Tympany at the top of abdomen
• Fluid wave
• Peripheral edema
• Shifting dullness (>500ml fluid)
• Bulging flanks (>500ml fluid)
Ascites in Dialysis Patients