How does ascites occur
Due to sodium and water retention as a result of cirrhosis and portal hypertension
Investigations
Shifting dullness on examination
US - to detect fluid
Management - rapid relief
Paracentesis
Management - general options
Paracentesis Diuretics - spironolactone TIPSS Reduce sodium intake Transplantation
Spontaneous bacterial peritonitis management
Urgent paracentesis
Antibiotics
Maintain renal perfusion
Low or high albumin
Low albumin