Medical history (history of illness) represents an important component in the diagnosis of ascites (abdominal dropsy). Family history Are there any diseases in your family (cardiovascular, tumor, liver diseases) that are common? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological … Abdominal Dropsy (Ascites): Medical History
Blood-forming organs-immune system (D50-D90). Hereditary angioedema (HAE) – due to C1 esterase inhibitor (C1-INH) deficiency (blood protein deficiency); approximately 6% of cases: Type 1 (85% of cases) – decreased activity and concentration of C1 inhibitor; autosomal dominant inheritance (new mutations about 25% of cases). Type II (15% of cases) – decreased activity with normal or … Abdominal Dropsy (Ascites): Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by ascites (abdominal dropsy): Respiratory system (J00-J99) Dyspnea (shortness of breath) Hepatopulmonary syndrome – disorder of pulmonary function due to severe acute or chronic liver disease such as cirrhosis. Hydrothorax – accumulation of water in the chest cavity. Liver, gallbladder, and … Abdominal Dropsy (Ascites): Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? Visible vessels? Scars? … Abdominal Dropsy (Ascites): Examination
1st order laboratory parameters-obligatory laboratory tests-. Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH), gamma-glutamyl transferase (γ-GT, gamma-GT; GGT), alkaline phosphatase, bilirubin. Amylase Albumin in serum (important protein/protein). Total protein in serum … Abdominal Dropsy (Ascites): Test and Diagnosis
Therapeutic target Flushing out ascites Therapy recommendations Basic therapy: maximum 3-6 g of table salt per day and fluid restriction (750-1,000 ml/d) – see under “Further therapy/nutritional medicine). Preferred use of spironolactone (aldosterone antagonists; first-line agent)[1]), if necessary in combination with loop diuretics or thiazide diuretics (draining drugs)This benefits patients with portal vein hypertension (high … Abdominal Dropsy (Ascites): Drug Therapy
Obligatory medical device diagnostics. Abdominal ultrasonography (ultrasound examination of abdominal organs) – for basic diagnosis [ascites detection: from 50-100 ml; predilection sites (preferred body regions): perihepatic (“around the liver”), perisplenic (“around the spleen”), and in the small pelvis (Douglas space)] Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory … Abdominal Dropsy (Ascites): Diagnostic Tests
In principle, for therapy of ascites, the underlying disease should be treated. In ascites due to liver disease, the following procedures can be performed in refractory cases. Paracentesis – ascites puncture for therapeutic reasons (method of choice); generally, 6-8 g of albumin (blood protein) should be substituted per liter of puncture to avoid hypovolemia (decrease, … Abdominal Dropsy (Ascites): Surgical Therapy
The following symptoms and complaints may indicate ascites (abdominal dropsy): Leading symptoms Increase in abdominal circumference (abdominal girth increase) → abdominal tightness, possibly pronounced abdominal pain. Extending flanks (when lying down). Spread navel Umbilical hernia Dyspnea (shortness of breath) Associated symptoms Anorexia (loss of appetite) with a rapid feeling of fullness. Nausea (nausea)/vomiting Singultus (hiccups) … Abdominal Dropsy (Ascites): Symptoms, Complaints, Signs
In addition to treatment of ascites (abdominal dropsy), therapy of the underlying disease is of primary importance. General measures Strive to maintain normal weight! Determination of BMI (body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised program for the underweight. Falling below the BMI … Abdominal Dropsy (Ascites): Therapy
