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ABDOMINAL GIRTH CAUSED BY MASSIVE ASCITES
ascitic (ă-sit′ik), adj.
Ascites may be caused by interference in venous return of the heart (as in congestive heart failure), obstruction of flow in the vena cava or portal vein, obstruction in lymphatic drainage, disturbances in electrolyte balance (as in sodium retention), depletion of plasma proteins, cirrhosis, malignancies (such as ovarian cancer), or infections within the peritoneum.
Ventilatory effort, appetite and food intake, fluid intake and output, and weight are assessed. The patient should be advised to limit fluid intake to about 1.5 L daily and be educated about a low-sodium diet. Both of these interventions may limit or slow the reaccumulation of fluid in the peritoneum. Abdominal girth is measured at the largest point, and the site marked for future measurements. Paracentesis, if necessary, is explained to the patient. Emotional and physical support are provided to the patient throughout the procedure. Desired outcomes include eased ventilatory effort, improved appetite, improved general comfort, and identification of the cause of the accumulated fluid.
Ascites is typically medically managed with a combination of diuretics, e.g. furosemide, a loop diuretic, and spironolactone, a potassium-sparing diuretic.