Prise en charge symptomatique de l’ascite maligne en phase palliative: place de la paracentèse et des diurétiques. Supportive care for malignant ascites in. Chez dix patients cirrhotiques porteurs d’une ascite sous tension, la pression voie endoscopique au moyen d’une fine aiguille, avant et après paracentèse. Mr G. presented for acute care 3 weeks ago with tense ascites, which was managed with a large volume paracentesis (LVP) of approximately 4 L. He was.

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Existing recommendations are old, and practices influenced by results obtained paracentesse non-neoplastic ascites.

The series explores common situations experienced by family physicians doing palliative care as part of their primary care practice. Sodium restriction First-line therapy includes sodium restriction. The indication of diuretic treatment is left to the appreciation of physicians. Portal hypertension and ascites.

Gale Encyclopedia of Medicine. Epub Sep 4. Views Read Edit View history.

Ascites in patients with cirrhosis

The needle is removed, leaving the plastic sheath to allow drainage of the fluid. From Wikipedia, the free encyclopedia. Conclusion Management of patients with ascites in end-stage cirrhosis is becoming more common in palliative care. Inguinal hernia surgery Femoral hernia repair.


Every 1 to 2 days, Mr G. Management of patients with ascites in end-stage cirrhosis is becoming more common in palliative care. Back to the case Mr G. Fundamental to the formation of ascites in cirrhosis pracentese portal hypertension, which causes splanchnic vasodilation, and activation of the renin-angiotensin-aldosterone system, further resulting in renal sodium retention.

Once ascitic fluid is mobilized and symptom control is achieved, the dosage of diuretics needs to be reconsidered with the goal of maintaining symptom control with the lowest dose of diuretics possible in order to prevent diuretic-induced side effects.

Malignant ascites, Paracentesis, Diuretics. Management of ascites in cirrhosis. Within 7 days, Mr G.

Large volume paracentesis, indwelling peritoneal catheters, or transjugular intrahepatic portosystemic shunts can be considered in refractory ascites. Indwelling peritoneal catheters The decision asicte to continue serial therapeutic paracentesis versus considering a permanent indwelling catheter is guided by the patient and his or her burden of disease, prognosis, and goals of care.

Support Center Support Center. While paracentesis and diuretics are commonly used, their efficiency has never been compared in a randomized controlled study. His last bowel movement was 3 days ago.


Current management of the complications of portal hypertension: National Center for Biotechnology InformationU.


First-line therapy includes sodium restriction. Natural history and prognostic indicators of survival in cirrhosis: The serum-ascites albumin gradient can help determine the cause of the ascites.

Additional evidences are required before guidelines can be established for the palliative management of malignant ascites. European Association for the Study of the Liver EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis.

The procedure is used to remove fluid from the peritoneal cavity, particularly if this cannot be achieved with medication. The fluid is drained by gravity, a syringe or by connection to a vacuum bottle. Access to the full text of this article requires a subscription. Fecal fat test Fecal pH test Stool guaiac test. New England Journal of Medicine. He also has moderate bilateral peripheral edema. Frey’s procedure Pancreas transplantation Pancreatectomy Pancreaticoduodenectomy Puestow procedure.

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