GI Disorders - Ascites

Question 1

What is Ascites?

Answer 1

accumulation of fluids in the peritoneal cavity

Question 2

Ascites is an example of ___ ____

Answer 2

Third Spacing

Question 3

Etiology of Ascites (4):

Answer 3

1. portal HTN
2. right sided HF
3. Na/H2O retention
4. severe changes in CHP and OP

Question 4

Patho of Ascites (4)

Answer 4

• portal HTN: non-functional fibrous tissue compresses blood vessels and vessels become engorged –> increase CHP force fluid to move out into ab cavity
• right sided HF: congestion and engorgement in R side of heart cause blood to back up in systemic circuit –> increase CHP –> force fluid to move out into abdominal cavity –> abdominal organ distention
• Na/H2O retention increase blood volume systemically and vessels become engorged–> increase CHP –> force fluid moves out to ab cavity
• severe changes in CHP and OP: increase in CHP or decrease in OP = ascites (disruption in CHP is affected by changes in BV and disruption in OP is affected by conc. of plasma proteins in blood)

Question 5

Manifestations of Ascites (2)

Answer 5

• Dyspnea: acum. of fluids increase pressure in abdominal cavity which restrict the movement of the diaphragm causing difficulty to breath
• Abdominal Distention: increase fluids in abdominal cavity

Question 6

Treatment of Ascites (3)

Answer 6

1. diuretics for small volume of 5L or less
2. correct fluid/electrolyte imbalance caused by fluid shift
3. Paracentesis with large volume of 5 L or more

Question 7

How does diuretics manage asictes?

Answer 7

• increase fluid loss
• decrease BV which decrease CHP in the blood
• stop fluid shifting from intravascular space

Question 8

What is Paracentesis?

Answer 8

aspirating a body cavity with a needle

Question 9

When using paracentesis, fluid must be drained ______ as draining _____ CHP in ab cavity and can cause fluids to shift from ______ to _____

Answer 9

gradually, decrease, vessels to cavity

Question 10

What are volume expanders? Why is it used during paracentesis?

Answer 10

volume expanders are agents such as albumin or plasma proteins that increases osmotic pressure

it is used during paracentesis b/c decreasing CHP by opposing it with increased OP will stop fluid from moving from the intravascular space and into the abdominal cavity