Ascites, which are popularly known as dropsy, are a condition characterized by accumulation in the abdominal cavity, the so-called free fluid. Its composition depends on the origin of ascites, the symptoms and causes of which will be discussed below. The volume of liquid can reach 25 liters.
Causes of ascites
The main reasons for the dropsy include the following:
- high pressure in the portal vein, which is typical for squeezing it with enlarged lymph nodes or a tumor, thrombosis, hepatitis, cirrhosis;
- compression of the hepatic veins due to venous congestion with heart failure or constrictive pericarditis;
- violation of lymph drainage;
- decrease in oncotic pressure, which happens with nephrosis, cachexia, alimentary dystrophy;
- bleeding into the abdominal cavity;
- inflammatory process.
Inflammation of an infectious nature, acute or chronic, becomes the cause of abdominal ascites in tuberculosis of the peritoneum. Infectious-allergic inflammatory process with increased permeability of blood vessels causes dropsy in acute glomerulonephritis , collagenoses. There are signs of ascites and with cancer peritonitis, which provokes non-infectious inflammation.
Signs of ascites in humans
The main symptom of dropsy is an increase in the size of the abdomen. The skin on it is stretched, it shines, the veins are clearly visible, especially at the navel. In the standing position, the stomach filled with a liquid slightly hangs down and protrudes laterally, if the patient is placed on his back. Other characteristic symptoms of ascites of the abdominal cavity are the protrusion of the navel region, and also the dull sound with percussion. In prone position, it is localized in the lateral parts. If the patient is put on his right side, percussion will show a dull sound in the left and vice versa. This sign of ascites is not characteristic for hydrocephalus of inflammatory origin due to shortening of the mesentery and fusion of loops of intestines with the abdominal wall and between themselves.
When diagnosing hydrocephalus, the doctor tapes on the stomach, putting the other hand on the opposite side: this helps to detect the presence of fluctuations, that is, fluctuations in the accumulated fluid.
If the cause of ascites is carcinomatosis of the peritoneum, it is possible to probe the seals, which are easily mobile; if bleeding occurs in the peritoneum - the skin around the navel becomes bluish.
Clarification of the nature of ascites
Fixing the symptoms of ascites, the doctor will not prescribe the treatment until a puncture is performed. This procedure involves a puncture of the abdomen below the navel and is performed both for therapeutic purposes (it is possible to lower pressure on the lower vena cava and improve blood circulation) and in diagnostic ones.
The accumulated liquid of its nature is classified into an exudate and an exudate. Exudate in turn can be serous, hemorrhagic, fibrinous, and chyle. The transudate, poor in protein, eventually becomes enriched with them, and the free liquid acquires the character of "transudate exudate".
Transudate is characteristic of ascites caused by heart failure, cirrhosis of the liver, constrictive pericarditis, mediastinal tumor, nephrotic syndrome, hepatic vein thrombosis, cancer (in half of cases), and alimentary dystrophy.
Exudate is found with collagenoses, peritonitis due to tuberculosis, cancer, infection. If the accumulated liquid
Chileous exudate with characteristic fat drops are detected in case of violation of lymph drainage through the thoracic duct due to compression by its enlarged lymph nodes or tumor. Pseudo-Cholesteric exudate with a small content of fatty drops is characteristic for rupture of ovarian cysts. If bile is found in the fluid, the bile duct rupture is indicated, although in rare cases it is observed after a liver biopsy.