Paracentesis

• Which is removal of ascitis fluid (4- 6L) from the abdominal cavity with a needle or catheter.

• Indicated in tense ascites.

• Fluid is rich in albumin ⇒ for every 1 L removed give 6-8g albumin.

Diuretics:Y

Diuresis should be gradual because hypokalemia or intravascular volume depletion caused by aggressive therapy compromised renal function, and hepatic encephalopathy.

Complications:

A-Hepatorenal syndrome:

Functional oliguric renal failure which occur as a serious complication in patient with cirrhotic ascites.

Causes: Any factor which decrease blood volume as :

1. G.IT bleeding due to rupture esophageal varices.
2. aggressive diuretics, paracentesis.
3. severe diarrhea.
4. others (urinary tract infection and nephrotoxic drugs as NSAId) May be reversed by liver transplantation