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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His last bowel movement was 3 days ago. Prospective evaluation of the PleurX catheter when used to treat recurrent ascites associated with malignancy. Small bowel Bariatric surgery Duodenal switch Jejunoileal bypass Bowel resection Ileostomy Intestine transplantation Jejunostomy Partial ileal bypass surgery Strictureplasty. Supportive care for malignant ascites in palliative phase: Heidelbaugh JJ, Sherbondy M.

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The procedure is used to remove fluid from the peritoneal cavity, particularly if this cannot be achieved with medication. In most cases, ascites is due to peritoneal carcinomatosis in which vascular permeability is paracenteze by VEGF production while lymphatic drainage decreases.

Ascites in patients with cirrhosis

A mg oral dose of metoclopramide is started 3 times daily before meals and a fourth dose at bedtime. Artificial extracorporeal liver support Bioartificial liver devices Liver dialysis Hepatectomy Liver biopsy Liver transplantation Portal hypertension Transjugular intrahepatic portosystemic shunt [TIPS] Distal splenorenal shunt procedure.

Epub Mar Transjugular intrahepatic portosystemic shunt A TIPS is a shunt between the portal vein and the hepatic vein, designed to reduce portal hypertension and improve renal sodium excretion by directly bypassing the cirrhotic parenchymal tissue. New England Journal of Medicine. The most common indication is ascites that has developed in people with cirrhosis.


The patient is usually discharged within several hours following post-procedure observation provided that blood pressure is otherwise normal and the patient experiences no dizziness. Fecal fat adcite Fecal pH test Stool guaiac test. Support Center Support Center. Medical management Decision making on the management of ascites depends on the severity of symptoms and not the presence of ascites in and of itself.

Permanent catheters can be under continuous or intermittent drainage, with the frequency determined by the patient in accordance with symptom control. The ascitic white blood parracentese count can help determine if the ascites is infected.

By using this site, you agree to the Terms of Use and Privacy Policy. Every 1 to 2 days, Mr G.

Ascites in patients with cirrhosis

What the exact risk of infection posed by an indwelling catheter is and whether or not patients paracetnese prophylactic antibiotics is not well defined in the literature. The procedure generally is not painful and does not require sedation.

He also has moderate bilateral peripheral edema. Radiographically, an abdominal ultrasound is useful in defining the extent of ascites in new-onset or worsening ascites.

Definition, features, and investigation Ascites is defined as the presence of excessive fluid in the peritoneal cavity. If you want to subscribe to this journal, see our rates You can purchase this item in Pay Per View: Ascites is defined as the paraentese of excessive fluid in the peritoneal cavity.

On examination, Mr G. Outline Masquer le plan.

Diagnostic peritoneal lavage Ascitf injection Laparoscopy Omentopexy Paracentesis Peritoneal dialysis. Malignant ascites, Paracentesis, Diuretics.

Despite this, Mr G. Appendicectomy Colectomy Colonic polypectomy Colostomy Hartmann’s operation. He is being seen today at home because of a rapid decline in function and escalation of symptoms. Bariatric surgery Duodenal switch Jejunoileal bypass Bowel resection Ileostomy Intestine transplantation Jejunostomy Partial ileal bypass surgery Strictureplasty. Diuretics Second-line therapy includes the use of diuretics.


But, available data is controversial, and there is no asfite factor to identify patients that respond to diuretic treatment.

Paracentesis – Wikipedia

Tunneled catheters are preferred over pigtail catheters owing to stability and lower rates of infection. Conclusion Management of patients with ascites in end-stage cirrhosis is becoming more common in palliative care. Views Read Edit View history. Several litres of fluid may be drained during the procedure; however, if more than two litres are to be drained paracentesf will usually be done over the course of several treatments. He is married and has 3 adult children. His overall appetite has declined, and this is distressing to his family.

Mild hematologic abnormalities do not increase the risk of bleeding. Ascites can also be secondary to portal hypertension, for example in case of multiple liver metastases, or due to lymphatic obstruction. Frey’s procedure Pancreas transplantation Pancreatectomy Pancreaticoduodenectomy Puestow procedure.


Management of ascites includes sodium restriction and use of diuretics. The series explores common situations experienced by family physicians doing palliative care as part of their primary care practice.

In an expert’s sscite it is usually very safe, although there is a small risk of infection, excessive bleeding or perforating a loop of bowel.