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Synopsis

This volume deals with the history, aetiology, pathophysiology, symptoms, signs, prognosis, and rational treatment of ascites. During the past decade, our knowledge of the pathophysiology of ascites has increased substantially and more specific therapies are now based on aetiology and pathophysiology. It is the intention of this book to review recent progress in pathophysiology of ascites and therapies based on pathophysiology. Although the different types of ascites have a different aetiology and very different pathophysiology, the development of fluid in the peritoneal cavity is always a bad clinical sign. It has a severe prognosis, which is mainly dependent on the aetiology and progression of the underlying disease. However, among patients with ascites, the prognosis may be very different, mainly owing to the presence of portal venous hypertension, malignancy in the abdominal cavity, and end-stage congestive heart failure. The addition of complications like the hepatorenal syndrome and bacterial peritonitis, whether spontaneous or secondary, adds heavily to the bad prognosis. Since hepatic ascites are by far the most complex with respect to pathophysiology, complications, and treatment, emphasis is put on the description of this entity. Ascites of other aetiologies are mentioned along with hepatic ascites, in particular, if the pathophysiology differs from ascites of hepatic origin.

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