Ascites
Ascites is the accumulation of excess free fluid in the peritoneal cavity (Fig. 5).
History
Symptoms
Patients with ascites can present with abdominal discomfort, increasing abdominal girth, weight gain and ankle or sacral swelling.
Onset
The development of ascites is usually gradual, but sudden onset can result from acute decompensation of liver cirrhosis, malignancy, portal or splenic vein thrombosis and Budd–Chiari syndrome.
Past medical history
Any history of malignancy in the abdomen or pelvis is relevant; however, abdominal metastasis can also result in ascites, especially from breast, ovarian, prostatic, testicular and haematological malignancies. Cirrhosis of the liver may result from alcoholism, previous hepatitis, Wilson’s disease, primary and secondary biliary cirrhosis and haemochromatosis. A previous history of TB should raise suspicion of secondary disease.
