Occurring in cirrhosis, the accumulation of fluid in the abdominal cavity, or
ascites, is related to portal hypertension, significant reduction in
serum albumin, and renal retention of sodium. The volume of abdominal
ascites in adults with cirrhosis may reach levels as great as 10 to 12
litres (10.6 to 12.7 quarts).
Ascitic fluid may accumulate in the scrotum and in the chest cavity, where its
presence, combined with the upward pressure on the diaphragm from the
abdominal fluid, may severely affect breathing. Appetite also is often
reduced by the abdominal distension.
Ascites are treated by the removal of enough fluid directly from the abdomen by
needle puncture to ease discomfort and breathing.
Patients are placed on diets low in salt, and they are given diuretic drugs to increase the output of water by the kidneys. If these measures do not control massive ascites, ascites can be drained internally into the general venous blood system by running a plastic tube from the abdominal cavity, under the skin of the chest, into the right internal jugular vein of the neck (peritoneovenous shunt of LeVeen).