Ascites
Introduction
Introduction Liver cirrhosis ascites is commonly known as liver ascites. Normal people have a small amount of free ascites in the abdominal cavity, usually about 50 ml, which plays a role in maintaining the lubrication between organs. When there is too much free liquid in the abdominal cavity, it is called ascites. Cirrhosis ascites is a chronic liver disease. From large, nodular, diffuse hepatic changes, necrosis, regeneration; regeneration, necrosis, promote tissue fibrosis and scar contraction, resulting in liver hardening, cirrhosis. Liver cirrhosis caused by portal hypertension, resulting in splenomegaly, protein fluid leaking from the absorption of protein and vitamins, formed ascites.
Cause
Cause
Cardiovascular diseases:
1. Chronic congestive right heart failure;
2, pericarditis: such as exudative pericarditis, chronic constrictive pericarditis;
3, thin Keshan disease.
Liver Disease:
1. Viral hepatitis;
2, cirrhosis;
3. Liver tumors.
Liver vascular disease:
1. Hepatic vein occlusion syndrome;
2. Portal vein thrombosis;
3. Inferior vena cava obstruction syndrome.
Peritoneal disease:
Peritonitis: such as exudative tuberculous peritonitis, acute pancreatitis complicated with peritonitis, paragonimiasi peritonitis, disseminated lupus erythematosus, cholesterol peritonitis, granulomatous abdomen;
Kidney disease:
1. Chronic nephritis with kidney disease;
2, nephrotic syndrome;
3, nutritional disorders of ascites.
Hypoproteinemia:
1, chylorrhea ascites;
2, hypothyroidism;
3. Meigs syndrome.
other reasons:
Caused by other reasons.
Examine
an examination
Related inspection
Liver function test lidocaine metabolism test liver palpation blood electrolyte examination liver ascites examination
Items for patients with hepatic ascites who need to be examined:
1 alpha fetoprotein (AFP) experiment: convection electrophoresis positive or radioimmunoassay determination > 400mg / ml, for four weeks and exclude pregnancy active liver disease and gonad embryo-derived tumors.
2 other signs check: alkaline phosphatase (A1 (P) about 20% of liver cancer patients increased, r-glutaminyltranspeptidase (r-GT) increased in most patients with liver cancer, 5-nuclear acid diester The majority of patients with enzyme isozyme V (5-PDase-v) xq have a higher positive rate of metastatic liver cancer in this enzyme, and -antitrypsin (-AT) is increased in about 90% of liver cancer patients. The content of 905 liver cancer patients increased, 70% of carcinoembryonic antigen (CEA) liver cancer patients, abnormal prothrombin>300mg/ml.
3 liver function and hepatitis B antigen antibody system check: liver function abnormalities and hepatitis B markers positive tips, liver disease based on primary liver cancer.
4 various imaging examinations: suggesting intrahepatic space-occupying lesions.
5 laparoscopy and liver puncture examination: laparoscopy can directly display the liver surface condition, liver biopsy.
Due to different physical symptoms, the specific examination items will depend on the degree of disease of the patient.
Diagnosis
Differential diagnosis
Differential diagnosis of liver ascites:
1, non-blood ascites: free liquid accumulated in the abdominal cavity. Normal people can have a small amount of liquid in the abdominal cavity to lubricate the internal organs. Ascites can be caused by diseases such as heart disease, liver disease, kidney disease, tuberculosis, malignant tumors, etc. It is a common clinical sign. According to its nature, it can be divided into leakage liquid or exudate; non-blood ascites can be divided into serous or chyle according to its appearance.
2, blood ascites: rupture of organs in the abdominal cavity, malignant tumors in the abdominal cavity may cause bloody ascites in patients. Among them, organ rupture is common in liver rupture, spleen rupture, uterine out-of-pregnancy leading to tubal rupture, hemorrhagic necrotizing pancreatitis
3, ascites: normal human abdominal cavity there is a small amount of liquid, generally not more than 200ml, when the increase in portal vein pressure, visceral artery dilation, plasma colloid osmotic pressure and other factors cause the amount of free fluid in the peritoneal cavity exceeds 1000ml, called abdominal cavity Fluid (ascites).
