Fluid builds up in the stomach. How to remove fluid from the abdomen. Treatment methods for the disease

Dropsy of the abdomen or ascites of the abdominal cavity is a disease in which the abdominal cavity is filled with fluid, and its amount can sometimes reach 20-25 liters. Because of this, the patient's stomach takes on enormous dimensions, causing him a lot of suffering.

Abdominal ascites, the treatment of which depends on its complexity, is not an independently occurring disease, it can be a symptom or a complicated consequence of other ailments, for example, oncological diseases with metastases in the stomach and the like. Its appearance indicates untimely or incorrectly carried out treatment of the underlying disease. The impetus for the development of ascites is a violation of the circulation of blood and lymph in the abdominal cavity (with the accumulation of transudate or non-inflammatory fluid) or inflammatory processes leading to the appearance of exudate or effusion. If an increased content of protein and leukocytes is found in the fluid, this is a formidable symptom indicating infection and multiplication of microorganisms, which is fraught with the development of ascites-peritonitis (inflammation of the peritoneum).

Forms of the disease and causes

Abdominal ascites is classified according to various criteria:

By the amount of liquid: small, moderate, or significant.
By the presence of microorganisms in the liquid: sterile or infected.
By responsiveness to drug therapy: amenable to conservative treatment or resistant to it (refractory). If fluid re-accumulation occurs, this is a sign that ascites has become stable, requiring more radical treatment.

Most often (in 80% of cases), ascites occurs against the background of liver cirrhosis, which has reached the final stage of decompensation. This stage is characterized by depletion of liver resources, serious disorders of the hepatic and abdominal circulation, that is, the appearance of favorable conditions for the accumulation of fluid.

In about 10% of cases, the causes of ascites are oncological diseases of the peritoneal organs with metastases in the stomach, ovarian cancer in women. This terrible ailment leads to difficulty in lymph circulation and blockage of the lymph outflow pathways, as a result of which free fluid in the abdominal cavity, having no outlet, begins to accumulate. Ascites caused by oncology is quite aggressive. Usually, its occurrence directly indicates the approaching death of the patient.

About 5% of the causes of ascites are heart diseases, accompanied by decompensation of blood circulation and general stagnation of blood in the body. "Cardiac" ascites often occurs against the background of swelling of the legs, and in especially severe cases, the body swells almost completely, right up to the armpits, fluid accumulates not only in the abdominal cavity, but also in the pleural cavity, that is, in the lungs.

In more rare cases, ascites develops against the background of kidney disease, pancreas, alcoholic hepatitis, peritoneal tuberculosis and stomach problems, for example, with its acute expansion.

Fluid in the abdomen is formed most rapidly in cancer, and most slowly in heart disease.

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Symptoms of pathology

Symptoms of ascites appear suddenly or accumulate gradually, over several months, until their combination forces the patient to be examined:

The main symptom is an increase in the volume of the abdomen. In a standing position, the abdomen sags noticeably, in a prone position it looks spread, with edges protruding on the sides. The navel is greatly expanded, with a very strong protrusion, an umbilical hernia may even develop.
Ascites caused by portal hypertension is easily recognizable by the characteristic pattern of venous vessels located on the skin of the abdomen in the navel area: they scatter in the form of rays. Doctors call this drawing "the head of a jellyfish".
Patients breathe heavily, shortness of breath is clearly visible. The reason for it is that the accumulated fluid in the abdominal cavity "lifts" the diaphragm from below, reducing the volume of the chest cavity and compressing the lungs, preventing them from completely expanding when inhaling.
Difficulty moving, inability to bend over.

The disease that led to the development of ascites can also affect the state of health typical for it. common symptoms: fever, symptoms of intoxication, weight loss with an enlarged abdomen, cyanosis of the extremities, expansion of the saphenous veins on the abdomen and so on.

A frequent consequence of ascites is an increase in intra-abdominal pressure, which, in turn, contributes to the occurrence of an umbilical hernia, hemorrhoids, varicocele, or rectal prolapse.

Is it possible to recognize the disease at an early stage?

In the initial stages of ascites, the signs of the disease are usually mild. The person is not disturbed pain, he can only sometimes complain of a feeling of fullness after eating in the stomach, heaviness and discomfort in the abdomen. But these symptoms are typical for many diseases.

A more or less accurate sign indicating the accumulation of fluid in the abdominal cavity is thirst, but diabetes must be completely excluded, since thirst is one of its most characteristic signs.

The enlargement of the abdomen does not occur immediately, but when there is already at least 1 liter of fluid in the abdominal cavity. An experienced doctor may notice that in the prone position, the patient's abdomen acquires a vague shape, and when pushing from one side, the movement responds in the other, a small wave seems to pass through the abdomen. However, it is almost impossible to understand this on your own.

If ascites is suspected, only ultrasound will give an accurate answer about the presence or absence of fluid in the abdomen in the early stages.

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Intra-abdominal fluid composition

The composition of the intra-abdominal fluid is quite complex and depends on many factors, in particular, on the underlying disease that triggered the development of ascites. Even patients with the same disease have different fluid compositions. For example, with ascites of the abdominal cavity, which has developed as a result of liver cirrhosis, the fluid in the early stages is saturated with protein and is of some value to the body. Therefore, it is inappropriate to withdraw it, sometimes it is better to “return” it to the body after “processing”.

That is why, during the initial diagnosis of ascites, fluid from the abdominal cavity is necessarily taken for research. The analysis will determine its composition, as well as the presence and degree of infection, which is a great danger and is often observed in patients with advanced liver cirrhosis. Infected fluid is a sign of developed ascites-peritonitis, which, if proper measures are not taken immediately, will inevitably lead to death.

Where does the infection in the abdominal cavity come from? Of course, it does not penetrate from the outside, its source is the human body itself. With prolonged presence of the intestine in a liquid medium, its walls are loosened, and their permeability increases. Infectious agents contained in feces can enter the liquid and begin to multiply in it. The symptoms of infection are fever and pain. Kidney function is disrupted, followed by a coma and death of a person in just a few days. Therefore, the state of infection of the intra-abdominal fluid is very dangerous, but, fortunately, from the moment of infection, it can sometimes take several weeks, which will be enough to provide the patient with the necessary assistance.

Analysis of the fluid, in addition to determining its composition and infection, helps to make an accurate diagnosis, that is, to identify the cause of ascites. The fact is that preliminary examination methods, for example, ultrasound, are not 100% reliable.

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Conservative, symptomatic and surgical treatment

Since ascites is only a consequence of the underlying disease, to eliminate it, it is necessary to eliminate the causes of the pathology that has arisen. One of 3 methods is chosen for treatment: conservative, symptomatic or surgical.

With uncomplicated ascites, treatment consists of normalizing liver function. This is achieved by drug therapy aimed at suppressing inflammatory processes in the hepatic parenchyma. The patient is prescribed diuretics to increase urinary excretion of sodium. Compliance with bed (sometimes half-bed) is prescribed to improve lymph flow and reduce the amount of liver metabolites. In ascites caused by portal hypertension, Albumin, hepatoprotectors and plasma administration are prescribed.

Symptomatic treatment is resorted to if conservative methods are ineffective, and there is no decrease in the amount of fluid. Then laparocentesis is performed - a puncture of the abdominal wall, followed by pumping out excess fluid. The procedure is performed under local anesthesia.

In one laparoscopy session, no more than 5 liters can be pumped out. The following procedures are scheduled at intervals of 3-4 days. Each subsequent procedure is more dangerous than the previous one, as it increases the possibility of damage to the intestines. In addition, with the fluid removed from the body, protein is washed out, which provokes the further development of ascites. Therefore, symptomatic treatment of abdominal ascites is not indicated for every patient.

With the rapid accumulation of fluid, the method of treatment is the installation of special drainage catheters, which allow the fluid to be constantly drained.

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With frequent and persistent relapses of ascites, an operation is prescribed, during which the portal and inferior vena cava are connected and collateral blood circulation is created. If, before the operation, the removal of ascystic fluid was repeatedly performed, plasma transfusion and a protein diet are additionally prescribed. In more severe cases, liver transplantation is necessary.

Diet

Diet for abdominal ascites is the most important factor in the successful fight against the disease on early stage... The diet is aimed at creating a negative sodium balance and saturating the body with proteins. Salt and fluid intake is minimized (up to 1 g of salt and up to 1 liter of fluid per day).

From products you can not use:

fresh pastries from butter dough;
fatty meat and poultry;
all kinds of sausages, smoked and canned foods;
strong broths made from red meat, fish, mushrooms;
whole milk;
hot and salty sauces;

all types of legumes;
millet;
hot and pungent vegetables: garlic, turnips, sorrel, radish, onion;
sweets, with the exception of jelly and marshmallows;
coffee;
alcohol;
cold drinks.

The patient must definitely eat:

parsley;
cucumbers;
lemons;
eggplant;
cabbage;
lean meat: rabbit, chicken, turkey;
skinless chicken broth;
boiled fish of low-fat varieties;
eggs in the form of an omelet;
sour cream (in very small portions);
porridge with diluted milk;
nuts;
dried fruits;
cottage cheese;
pomegranate juice diluted with water.

Food should be steamed and without salt. Avoid fried, and eat vegetables stewed, boiled or baked.

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Forecast

To a large extent, it depends on the underlying disease that caused ascites (diabetes mellitus, liver cancer, spontaneous bacterial peritonitis, and others) and the effectiveness of its treatment. However, for 50% of patients with ascites, the disease is fatal within 2 years. If diuretics become completely ineffective, half of the patients live no more than six months.

Ascites is a pathology that requires urgent medical attention. If you let the disease take its course, without taking any measures, it will progress steadily. At the slightest suspicion of the presence of fluid in the abdominal cavity, an immediate examination should be carried out to confirm or exclude ascites. Timely treatment started will help to significantly alleviate the patient's condition and increase the chances of a favorable prognosis for the development of the disease.

Some organ diseases lead to abnormal enlargement of the abdomen. Abdominal ascites (also called dropsy of the abdominal cavity) appears due to prolonged and chronic disruption of the work of the heart muscle, liver, kidneys or oncology. Due to the accumulation of free fluid in the abdomen, the patient experiences discomfort.

Treatment of dropsy of the abdomen is aimed at eliminating the cause of the disease. If too much exudate has accumulated, it must be surgically removed. In some cases, up to 25 liters of pathological fluid are noted.

Ascites - what is it

A healthy person has some liquid in the abdomen, which is constantly absorbed and distributed through the lymphatic vessels. The definition of ascites refers to the pathological accumulation of inflammatory exudate or transudate in the peritoneum.

According to the accumulated volume of fluid in the abdomen, the following stages of dropsy are distinguished:

Transient ascites. No more than 500 ml of fluid accumulates in the peritoneum. Such a condition cannot be determined independently or by palpation of the abdomen, there are no symptoms. Therefore, the patient at the first stage does not suspect about the presence of pathology.

Moderate ascites. Up to 4 liters of exudate accumulates in the stomach. The patient feels discomfort, dropsy is visible and is expressed in a hanging abdomen. It is diagnosed by examination and palpation of the site of edema.

Intense ascites. The liquid accumulates in a large volume, in the walls of the peritoneum there is from 10 liters of exudate. Internal organs are under great pressure, renal blood flow is disturbed. The abdomen expands, the right and left side increases.

Chylous ascites. A rare complication that indicates the last degree of cirrhosis. A white liquid containing fat collects in the peritoneum.

A variety of chronic or advanced organ diseases can provoke ascites: tuberculous peritonitis, portal hypertension, heart failure, cirrhosis of the liver, peritoneal carcinomatosis, and gynecological diseases. Treatment of ascites formed in the abdominal cavity consists in the diagnosis and elimination of the factors that provoked it.

Ascites in heart failure

The accumulation of abnormal fluid in the walls of the abdominal and abdominal cavity sometimes occurs due to heart problems. This factor provokes ascites in 5% of cases. Dropsy of the abdomen is caused by the inability of the enlarged heart to pump enough blood.

The main diseases of the heart muscle and blood vessels of the system, which lead to stagnation and accumulation of pathological fluid:

trauma to the heart;
overload of the heart and stretching of its walls due to hypertensive crisis,
arterial hypertension, heart disease;
cardiomyopathy: thinning or thickening of the organ wall.

Also, the symptoms of dropsy are observed with constrictive pericarditis. Any pathology and disturbance in the work of the heart can lead to heart failure and the development of ascites.

This complication cannot be ignored, since it speaks of ineffectiveness or lack of proper treatment of the causative disease. An urgent removal of the pathological fluid is mandatory.

Dropsy with cirrhosis of the liver

In 80% of cases, free fluid stagnates in the walls of the abdominal cavity as a result of advanced cirrhosis. With this disease, blood flow is disturbed, the production of plasma proteins, the level of albumin decreases, changes in the blood vessels of the liver, the serous membrane is covered with scars. Due to these changes, the organ becomes larger and begins to put pressure on the portal vein.

The accumulation of fluid in the abdomen occurs with the following types of cirrhosis:

primary biliary;
secondary;
congenital.

The main symptoms of abdominal dropsy in cirrhosis are an increase in the volume of the abdomen against the background of a sharp loss of total weight, shortness of breath and increased fatigue. The enlargement of the abdomen indicates an almost complete replacement of healthy liver tissue with non-functional. The patient needs to be hospitalized and an effective treatment is urgently prescribed.

Chylous ascites

The last stage of liver cirrhosis provokes the accumulation of lymph in the walls of the peritoneum and abdominal edema. Ascitic fluid has a characteristic color and composition: milky with impurities of fat.

In addition to the increase in volume, the patient has a breathing disorder, swelling of the face and legs.

The causes of abdominal ascites in this case are as follows:

hydrostatic hypertension;
operations on the organs of the abdominal cavity;
tuberculosis;
pancreatitis;
trauma to the liver, stomach, duodenal colon, intestines and gallbladder.

Chylous ascites is treated with nutritional correction. The diet is prescribed tough. It is aimed at the complete elimination of foods that provoke the accumulation of internal fat from the diet.

Chylothorax

With trauma or pathologically enlarged lymph nodes in the pleural region, fluid accumulation in the lungs may develop. Among the main symptoms of this complication of ascites, there are shortness of breath, a feeling of heaviness in the chest, and a violation of the heartbeat.

This phenomenon is diagnosed after studying the composition of the accumulated liquid. As a rule, it is white and contains a large number of lymphocytes. Treatment of pulmonary dropsy is similar to the treatment of abdominal ascites: dietary nutrition, drug therapy, in the absence of a result - laparocentesis of the pleural cavity.

Causes of abdominal edema

In the presence of serious diseases, a man or woman has a complication in the form of ascites. The stomach swells gradually. It is possible to determine why a large amount of fluid accumulates in the peritoneum only with the help of diagnostics.

The main causes of dropsy in the abdomen:

liver pathologies: cirrhosis, liver failure, malignant and benign
neoplasms, Budd-Chiari syndrome;
kidney disease: inflammation, urolithiasis;
diseases of the heart and blood vessels: heart failure and other pathologies leading to it;
pleural edema;
rhesus conflict between woman and fetus;
oncology: tumors of the stomach on the left side, cancer of the abdominal cavity organs;
diseases of the stomach, intestines, gallbladder;
lack of balanced nutrition, starvation, prolonged strict diet.

Abdominal ascites is diagnosed not only in adulthood in men and women, there is also congenital dropsy. It can form due to hemolytic disease or latent bleeding.

For the treatment of pathology, it is necessary to make a fluid puncture. If doctors diagnose chylous ascites when fat levels are elevated in the accumulating exudate, a strict diet is prescribed.

How to recognize pathology

The symptoms of dropsy are pronounced, the volume of the abdomen increases pathologically, the general state of health worsens. However, an increase in the size of the peritoneum can also speak of pacreatitis, accumulation of feces, pregnancy. If the abdomen sags down while standing, and lying down it spreads to the left and right, this is dropsy.

In addition to puffiness, the following signs of ascites are distinguished:

shortness of breath, cough, in the supine position it is difficult to breathe;
with an increase in the abdomen, it begins to hurt in the pelvis;
frequent and painless urination, the volume of urine is not increased;
violation of the function of defecation;
swelling of the abdomen;
distension of the abdomen;
violation of the heart rhythm;
heartburn, frequent belching;
bulging navel, hemorrhoids;
weakness, drowsiness, apathy.

Also, in the case of the last stages of chronic diseases, the swollen stomach hurts, interferes with normal movement and breathing. Due to circulatory disorders, the face, legs and arms are also swollen. When bending forward, it hurts in the lower abdomen. Signs of dropsy exacerbate the causative illness.

Diagnosis of ascites

Abdominal enlargement is not the only sign of ascites, therefore, after examination and palpation, laboratory and instrumental diagnostics are prescribed. The presence of fluid in the walls of the peritoneum helps to distinguish complications from obesity.

To confirm the presence of ascites and determine its cause, doctors use the following research methods: local ultrasound examination of organs; puncture of the abdominal cavity; assessment of the quality and quantity of ascitic fluid; laparocentesis with ascites; laboratory study of the composition of the liquid.

If the transudate contains less than 500 μl-1 leukocytes, and neutrophils up to 250 μl-1, dropsy is diagnosed. An increase in the latter indicator indicates the presence of an infectious agent, for example, with tuberculous peritonitis.

How to treat abdominal ascites

Treatment of ascites consists in eliminating the causative disease and reducing fluid in the peritoneum. You can get rid of the abdomen with the help of therapeutic paracentesis: puncture and pumping up to 4 liters per day. Also, to cure dropsy of the abdomen, the doctor prescribes a special diet and bed rest.

Drug treatment

If ascites is initial or moderate, the attending physician will prescribe medication. The main pharmaceuticals are diuretics that prevent the stagnation of excess fluid. The most popular diuretics for ascites are Aldactone, Amiloride, Veropshiron.

Also, vitamins (vitamin C and P) and medicinal tablets ("Diosmin", "Reopolyglucin") are prescribed to strengthen blood vessels. If the patient has chylous ascites, the patient is injected with an intravenous solution of Albumin. If pathogenic bacteria are found in the liquid, antibacterial therapy is used.

Surgical intervention

If a drug treatment ascites does not bring results and a stable form of complication is observed, the doctor prescribes abdominal laparocentesis.

The liquid is pumped out gradually with the introduction of a 0.5% solution of novocaine. Do not remove more than 4 liters of exudate at a time.

Removal of abdominal fluid is carried out on an empty stomach, 5 liters of exudate is removed at a time. After laparocentesis, the pumped-out fluid is sent for examination, and the abdominal cavity is again examined using ultrasound.

If dropsy is a consequence of peritonitis, surgical treatment is prescribed only during the occurrence of adhesions in the abdominal cavity, which mechanically affect the intestines and provoke intestinal obstruction. After the operation, the patient is assigned to bed rest and a strict diet.

Traditional methods

Treatment of dropsy of the abdomen using alternative medicine is carried out only in combination with drug therapy.

IN folk recipes contains diuretic plants that help get rid of some of the fluid in the peritoneum:

hernia and bearberry;
mother-and-stepmother and linden;
parsley;
flax seeds;
birch buds and leaves;
corn silk, horsetail, bean pods;
ready-made pharmacy preparations with a diuretic effect.

From the listed products, teas, decoctions and infusions are prepared that contribute to the natural excretion of fluid. Also, for the treatment of ascites at home, an infusion of cherry stalks is used. It is necessary to mix half a liter of boiling water and 25 grams of raw materials and insist in a dark place for several hours. Drinking such a mixture is recommended for three glasses a day.

Diet food

Diet for ascites is one of the main treatments. The main prohibition is the refusal or the use of up to 1 gram of salt per day.

Diet food consists of a large number of vegetables and fruits: cucumbers, eggplants, cabbage, pomegranate, lemon, dried fruits. Parsley is allowed from spices. All food should be steamed or baked. Porridge and soups are made with lean broth. It is also recommended to drink up to 1 liter of liquid per day.

Ascites in children

Ascites in children at birth occurs due to intrauterine infection or maternal health problems. It is also possible pathological development of internal organs due to a genetic malfunction. If a woman is diagnosed with syphilis, rubella, or toxoplasmosis during pregnancy, there is a high likelihood of having a baby with dropsy. The enlarged peritoneum presses on the internal organs and disrupts their normal functioning.

A newborn or older child should be treated immediately. The doctor prescribes diuretics, vitamins and hormones. If parents notice swelling of the child's abdomen, do not treat it yourself, contact the pediatrician.

How many live with ascites

Treatment of abdominal ascites cannot be ignored. By itself, dropsy will not dissolve, the volume of fluid will increase. The huge belly will begin to press on the internal organs, which will gradually fail.

The prognosis of life expectancy depends on the cause of the complication. People with cirrhosis of the liver require a transplant of the affected organ, otherwise the patient dies. Even with a successful transplant, the maximum life span is 5 years. If kidney failure is diagnosed, there will be no chance of survival.

With oncology and chylous ascites, fluid in the abdomen quickly accumulates. Therefore, the life expectancy of patients with this diagnosis is minimal.

Can ascites be cured? Drug therapy in the early stages of the disease will significantly alleviate the patient's condition. If parocentesis is prescribed for ascites, fluid returns over time and a new operation is required. It is impossible to completely cure this pathology.

Effects

Prolonged accumulation of fluid in the walls of the peritoneum leads to many consequences and complications that are not compatible with life.

If the patient did not seek medical help on time, the following pathologies are observed:

peritonitis;
heart diseases;
hydrothorax - the accumulation of fluid in the pulmonary cavity;
accumulation of fluid in the scrotum;
the formation of a diaphragmatic or umbilical hernia;
intestinal obstruction;
respiratory failure;
reflux esophagitis - inflammation of the esophagus.

In case of complications, it is necessary to urgently remove the infected fluid in the cavity. The consequences of dropsy are also treated: drug therapy and surgery (cleaning the intestines, pumping fluid from the lungs or scrotum, transplanting the affected organ).

Prevention

Dropsy of the abdomen is a complication of serious diseases of the internal organs. It does not occur in a healthy person.

To prevent excess fluid from appearing in the abdominal cavity, you should adhere to the basic rules:

Regular doctor visits to monitor your health. Control of the content of total bilirubin, leukocytes, protein in the blood.
Timely treatment of diseases of the liver, kidneys, heart defects, gastrointestinal tract, organs of the genitourinary system.
If you have pancreatitis, stick to your diet. Completely eliminate fatty foods and alcohol.
During pregnancy, do not skip screening.

A healthy lifestyle, the absence of stress and overstrain significantly reduces the likelihood of ascites. The expectant mother is prohibited from smoking and drinking alcohol, as well as from carrying infectious diseases on her legs.

Abdominal dropsy or ascites is a buildup of large amounts of fluid in the abdomen. The belly swells to a huge size, the navel protrudes outward and stretch marks radiate from it. The skin on the abdomen is so stretched that the capillaries shine through it.

Dropsy is not an independent disease, it occurs against the background of diseases of the internal organs. Ascites is dangerous because it puts pressure on the abdominal organs and disrupts their functioning.

Fluid builds up in the abdomen for several reasons:

thrombosis of the hepatic and portal veins due to cirrhosis of the liver causes pressure and the plasma of internal organs begins to seep into the abdominal cavity and accumulate;
persistent liver inflammation due to alcoholic hepatitis, which is caused by intoxication;
with heart failure, edema occurs, which is the reason for the release of plasma and accumulation in the abdomen;
alimentary dystrophy;
imbalance of salt and water in the body;
pathologies in which the outflow of lymph in the chest is disturbed;
malignant tumors with metastases;
tuberculous process of the abdominal cavity;
diseases of the pancreas.

Dropsy can be caused by several reasons at once, then the patient's condition is classified as very serious.

The development of dropsy in children

Dropsy of the abdominal cavity can occur in newborns due to congenital, hereditary and acquired pathologies.

Among the congenital, there are three:

incompatibility of the child's and mother's rhesus;
swelling due to internal blood loss;
nephrotic syndrome.

Hereditary pathology can be talked about when it comes to exudative enteropathy. Also, edema could be provoked by damage to the bile ducts and disorders of the digestive system, as well as the development of a severe form of dystrophy. In adolescents, the reasons for the development of dropsy are the same as in adults.

Signs of dropsy of the abdomen are pronounced:

the belly increases to the size of an inflated ball gradually or rapidly;
the abdomen strongly protrudes or hangs down, spreads when lying down;
strongly dilated veins around the navel are visible.

According to the symptoms of abdominal dropsy, it is divided into types:

initial stage - accumulation of liquid in an amount not exceeding 1.5 liters;
moderate ascites - swelling of the legs and chest, accompanied by shortness of breath, a feeling of heaviness in the abdomen, heartburn and constipation;
massive - the volume of fluid exceeds 5 liters, a dangerous condition for a person, characterized by heart failure, respiratory failure, the risk of developing peritonitis, as a rule, ends in death.

The composition of the abdominal fluid is divided into:

sterile, in the absence of bacteria;
an infectious disease if bacteria are found.

Also, dropsy of the abdomen is divided according to the possibility of cure:

ascites of the abdominal cavity, which can be treated with drugs;
persistent dropsy, rather repeated, which cannot be treated with medication.

Signs by which ascites can be suspected:

respiratory failure;
enlargement of the abdomen;
swelling of the legs;
constant belching and heartburn;
pain in the abdomen and a feeling of fullness;
in men, swelling of the scrotum.

If the dropsy is caused by thrombosis of the hepatic veins, then the veins are clearly visible in front and on the side of the abdomen. If thrombosis occurs in the vessels that are located under the liver, then the patient will be tormented by vomiting, nausea and yellowness of the sclera and skin.

If we are talking about a tuberculous process, arrhythmia, general weakness are added to the listed symptoms, the patient quickly gets tired, he is tormented by a headache.

Diagnostics

To diagnose dropsy of the abdomen, ultrasound of the abdominal cavity, veins and vessels of the abdomen is used. Ultrasound is mainly performed to identify oncology and to determine the nature of the dropsy itself. If the dropsy is treatable, the doctor will prescribe a course of drug therapy.

If oncology is found, the patient can be operated on. A blood test from a vein can confirm liver cirrhosis or cancer that causes fluid to build up.

Angiography is performed to diagnose blood vessels. X-ray of the lungs can determine the stage of tuberculosis and the presence of edema. Also, laboratory tests of the abdominal fluid are carried out.

First of all, a diet is prescribed that excludes:

the use of spicy vegetables - radishes, garlic, onions, radishes;
sorrel, cabbage, heavy for digestion;
citrus fruit;
fatty and heavy foods;
alcohol, carbonated drinks, including beer;
salt and pickles;
lean meats and fish.

The diet should be aimed at weight loss, at least 2 kg per week. If the diet does not work, then the patient is hospitalized.

In a hospital setting, diuretics are used, and the level of electrolytes in the blood is controlled. In a severe case, an operation is prescribed.

Modern medicine offers several options:

establish a peritoneovenous shunt;
make a puncture of the abdominal wall to extract the transudate;
do a liver transplant.

Most often, a puncture is made and fluid is pumped out; this procedure does not require general anesthesia. Liver transplant is done for different stages of oncology.

Liquid is not pumped out if infectious diseasesAlso, the procedure has a number of contraindications.

There are some home remedies for ascites:

pumpkin porridge and pumpkin pieces baked in the oven;
a decoction of parsley is used as a diuretic;
a decoction of bean pods is also used as a diuretic;

As a prevention of dropsy of the abdomen, there should be timely treatment of diseases of the internal organs. When edema appears, you must give up excess fluid, salt and coffee.

It is necessary to consult a doctor if you suspect the development of ascites and not to self-medicate, so as not to aggravate the condition.

The reasons for the accumulation of fluid in the abdominal cavity depend on many different factors and dangerous conditions. it abdominal dropsy, which can show gastroenterological problems, gynecological disorders, oncology, urology, even may indicate cardiac pathologies.

This condition is accompanied by an increase in intra-abdominal pressure, the diaphragm rises closer to the chest, which makes breathing difficult. It is an aesthetic and physiological problem that significantly worsens the prognosis of an existing disease.

Diseases that provoked unpleasant symptoms due to a worsening of the patient's condition are considered factors of the appearance of ascites:

Portal hypertension... This disease is characterized by increased pressure in the portal vein. It ensures proper circulation of blood through the gastrointestinal tract and its pathologies occur quite often. This disease is characterized by the fact that liver functions are not fully performed. The disease manifests itself very clearly, since there are disturbances in the digestive process, as well as dangerous manifestations of the disease, characterized by metabolic disorders.
Cirrhosis of the liver... A dangerous and difficult disease to cure, which must be eliminated in the shortest possible time.
Alcoholic hepatitis B.Severe inflammation of the liver manifests itself, which began due to its poisoning with toxic substances that have entered as a result of alcohol consumption. First of all, it is necessary to abandon all alcohol-containing drinks, then all forces should be directed towards curing the disease.
Carcinomatosis of the peritoneum... This is a disease characterized by the presence of malignant cells outside or inside the peritoneum. Various tumors and simply altered cells can cause dropsy of the abdomen.
Heart failure... If the blood flow to the heart is disturbed, all organs suffer, which leads to blood stagnation. As a result, the accumulated fluid increases, which causes a rapid increase in the abdomen and inconvenience for the patient.
Liver failure... Usually ascites in this case occurs not simply in the case of a decrease in liver function, but when chronic inflammation or death of liver tissue. If cells cannot perform their functions for a long time, the process of processing proteins gets confused. Too little protein in the blood leads to the fact that fluid is released from the vessels and enters the abdominal cavity. Liquid lingers insidecausing unpleasant symptoms.
Hypoproteinemia... It manifests itself in kidney pathologies, it is especially dangerous or strong if a person has undergone a debilitating diet.
Peritoneal tuberculosis.This is a very rare disease, but it can manifest itself with weakened immunity.
Pancreatic pathology... In most cases, they manifest in the abdomen if severe pancreatitis is characterized by complications.

Symptoms

There are a number of dangerous situations that need to be noticed as quickly as possible:

Abdominal enlargement... When the patient is standing, the pathology is especially visible. The abdomen seems to hang down, looks burdened. If a person lies down, the stomach looks flat. The side surfaces never sink in, protrude slightly or stand out strongly.
Umbilical ring syndrome is formed... The navel constantly expands to the point when it becomes convex, which often provokes the occurrence of a hernia.
In some cases, the accumulation of fluid in the abdominal cavity is considered the result hypertension... A disease in which there is an increase in pressure in the portal vein, through which venous blood circulates through the gastrointestinal tract. Also, in many cases, the accumulation of fluid inside the abdomen is associated with liver problems. Then the skin on the abdomen does not look smooth, but is decorated with bright venous vessels. They do not look asynchronous, as they visually form a cobweb, radiating away from the bunch.
Patients complain of heavy breathing and persistent shortness of breath. This syndrome is formed due to the fact that a significant part of the fluid in the abdomen is invariable. raises the diaphragm. Because of this chest cavity decreases, which does not allow it to provide sufficient volume for air to enter and exit without tension.

The accumulation of fluid inside the abdomen is never an independent disease, but only a symptom of other, basic pathologies that require immediate study.

To cure ascites, it is necessary to clearly define the pathology that led to its formation.

After operation

During surgery on internal organs, one of the complications is the accumulation of fluid in the abdominal cavity. In most cases, doctors warn about this in advance, and also conduct the necessary research in order to exclude the likelihood of this disease.

If there is inflammation of the internal organs, the likelihood of fluid accumulation inside the abdomen increases. To remove it, there is no need for a second operation. Doctors easily solve this problem, after carrying out a simple puncture procedure, followed by the withdrawal of fluid under local anesthesia.

Treatment

To cure the accumulation of fluid inside the abdomen, it is necessary to resort to complex measures using the main therapeutic techniques:

Getting rid of the underlying disease... In most cases, ascites is caused by chronic pathologies. It is quite difficult to treat them, since it is necessary to bring the condition to a long-term remission, as a result, to ensure that the pain completely leaves the person. If you constantly spend adequate treatment, the risk of ascites is reduced.
Diet... You should constantly monitor your diet, eat food that contains a large amount of protein.
Don't neglect taking diuretics, especially if they are necessary for your body.
Conducting laparocentesis. A mild pain reliever is used, since the process takes a minimum amount of time. The wall is pierced with a specialized medical device designed for this surgical intervention. Due to the puncture, the liquid is completely released. This method is used quite often, but it is not effective enough if it is not combined with a competent course of therapy. If the main disease does not leave the patient, there is a high probability that the fluid will form again and even more than before.
Operationwhich led to the accumulation of fluid in the abdomen. Especially often the operation is indicated for hypertension. Vascular surgery is required, in which measures are provided that serve to improve blood flow.This will not only reduce the likelihood of recurrence of fluid accumulation in the abdomen, but also ensure good blood circulation through the gastrointestinal tract, save a person from liver pathologies.

The accumulation of fluid in the abdomen is a dangerous condition, but it can be treated using standard medical methods. If the underlying disease is cured, relapse of ascites will not appear.

If left unattended, as a result of multiple dysfunctions of internal organs, it worsens prognosis of the underlying disease, and also the patient's condition is aggravated.

The accumulation of free fluid in the abdominal cavity occurs as a result of an inflammatory reaction, impaired lymph flow and blood circulation due to various reasons. This condition is called ascites (dropsy), and its appearance can lead to the development of serious consequences for human health.

The fluid accumulated in the peritoneum is an ideal habitat for pathogenic microflora, which is the causative agent of peritonitis, hepatorenal syndrome, umbilical hernia, hepatic encephalopathy and other equally dangerous pathologies.

To diagnose ascites, one of the safest and most non-invasive, but highly accurate methods is used - a study using ultrasound waves. Detection of the presence of fluid in the abdominal cavity by ultrasound is carried out as directed by the attending physician based on the existing clinical signs of the pathological process.

The abdominal cavity is an anatomically separate zone, which constantly releases moisture to improve the sliding of the visceral sheets of the peritoneum. Normally, this effusion is able to be absorbed dynamically and not accumulate in areas convenient for it. In our article, we want to provide information on the causes of abnormal fluid reserving, diagnosis of a pathological condition by ultrasound and effective methods of its treatment.

Why does free fluid accumulate in the abdominal cavity?

Ascites develops due to various kinds of pathological processes in the pelvic organs. Initially, the accumulated transudate does not have an inflammatory nature, its amount can range from 30 ml to 10-12 liters. The most common causes of its development are impaired secretion of proteins, which ensure the impermeability of tissues and pathways that conduct lymph and circulating blood.

This condition can provoke congenital anomalies or development in the body:

cirrhosis of the liver;
chronic heart or kidney failure;
portal hypertension;
protein starvation;
lymphostasis;
tuberculous or malignant lesions of the peritoneum;
diabetes mellitus;
systemic lupus erythematosus.

Often, dropsy develops with the formation of tumor-like formations in the mammary glands, ovaries, digestive organs, serous membranes of the pleura and peritoneum. In addition, free fluid can accumulate against the background of complications of the postoperative period, pseudomyxoma of the peritoneum (accumulation of mucus that undergoes reorganization over time), amyloid dystrophy (violation of protein metabolism), hypothyroid coma (myxedema).

The mechanism of formation of dropsy is the seepage into the abdominal cavity of fluid from the main lymphatic ducts, blood vessels and organ tissues

Signs of ascites

In the early stages of the development of this condition, patients do not have any complaints, the accumulation of free fluid can only be detected using ultrasound. Visible symptoms appear when the amount of transudate exceeds one and a half liters, a person feels:

an increase in the abdominal abdomen and body weight;
deterioration in general health;
a feeling of fullness in the abdominal cavity;
swelling of the lower limbs and scrotal tissues (in men);
belching;
heartburn;
nausea;
difficulty breathing;
flatulence;
tachycardia;
protrusion of the umbilical node;
discomfort and pain in the abdomen;
stool and urinary disorders.

When a large amount of effusion accumulates in the peritoneum, a person can hear a characteristic splash of fluid and feel a wave.

If an ultrasound examination of the abdominal cavity has shown that there is excess moisture, the attending physician must accurately establish the root cause of the pathological condition. Pumping out the accumulated transudate is not effective method treatment of ascites.

Preparation for ultrasound and the course of its conduct

This study does not have any contraindications or restrictions, in emergency cases it is carried out without preliminary preparation of the patient. A planned procedure requires improved visualization of pathological changes in organs. The patient is recommended, 3 days before the study, to exclude from the diet foods containing a large amount of fiber and increasing gas production.

On the eve of the study, drink a laxative or do a cleansing enema. To reduce the accumulation of gases in the intestines on the day of the ultrasound scan, you need to take Mezim or activated carbon. Modern methods of ultrasound diagnostics make it possible to determine the most likely areas of accumulation of free fluid in the abdominal cavity.

That is why qualified specialists inspect the following anatomical areas:

The upper "floor" of the peritoneum, which is located under the diaphragm. Of particular diagnostic value are the spaces located under the liver and formed by the main section of the small intestine - the ascending and descending parts of the colon. Normally, the so-called lateral canals do not exist - the integument of the peritoneum is tightly attached to the intestine.
The small pelvis, in which, with the development of pathological processes, an effusion can accumulate, flowing from the lateral canals.

The physical characteristics of moisture accumulated in the peritoneum for any reason do not allow the ultrasound wave to be reflected, this phenomenon makes the diagnostic procedure as informative as possible. The presence of effusion in the examined anatomical spaces creates a dark moving focus on the monitor of the apparatus. In the absence of free fluid, the diagnosis takes no more than 5 minutes.

To detect excess moisture, the ultrasound probe is moved along the anterior and middle axillary lines on both sides of the patient's body down the abdomen

If the transudate cannot be detected, indirect signs may indicate its presence:

displacement of the loops of the colon;
sound change during percussion (tapping) - tympanic in the upper parts of the peritoneum, dull in the lower.

Types of abdominal dropsy by ultrasound

International classification of diseases does not distinguish ascites as a separate disease - this condition is a complication of the last stages of other pathological processes. According to the brightness of clinical symptoms, the following forms of ascites are distinguished:

initial - the amount of water accumulated inside the abdomen reaches 1.5 liters;
with a moderate amount of liquid - manifested by swelling of the legs, a noticeable increase in the size of the chest, shortness of breath, heartburn, constipation, a feeling of heaviness in the abdomen;
massive (the volume of effusion is more than five liters) is a dangerous condition characterized by tension in the walls of the abdominal cavity, the development of cardiac insufficiency and respiratory systems, infection of the transudate.

In bacteriological assessment of the quality of free liquid, which is produced in special laboratory conditions, a distinction is made between sterile (absence of pathogenic microorganisms) and infected (presence of pathogenic microbes) dropsy.

According to diagnostic forecasts, there is ascites, which is amenable to drug therapy, and a stable pathological condition (its re-occurrence or not amenable to treatment).

What is done after confirming the pathology with ultrasound?

The course of treatment depends on the disease caused by the accumulation of excess moisture in the peritoneum. To accurately diagnose the pathological process, practicing specialists conduct a comprehensive examination of the patient, including:

biochemical and general clinical analyzes of blood and urine;
research on oncological markers and indicators of electrolyte metabolism;
survey radiography of the chest and abdominal cavities;
coagulogram - evaluation of the parameters of the coagulation system;
angiography of blood vessels, allowing to assess their condition;
MRI or CT of the abdomen;
hepatoscintigraphy - a modern technique for examining the liver using a gamma camera, which allows visualizing an organ;
diagnostic laparoscopy with medical puncture of ascitic fluid.

To pump out the transudate from the abdominal cavity, the method of therapeutic laparocentesis is used - a puncture is made in the anterior wall of the abdomen, through which excess fluid is removed

Patients with cirrhosis of the liver are recommended to undergo intrahepatic portosystemic shunting, the technique of which consists in placing a metal mesh stent to create an artificial connection between the collar and hepatic veins. If the disease is severe, organ transplantation is necessary.

In conclusion of the above information, I would like to emphasize once again that the accumulation of free fluid in the abdominal cavity is considered an unfavorable manifestation of the complicated course of the underlying ailment. The development of ascites can provoke a violation of the functional activity of the heart and spleen, internal bleeding, peritonitis, cerebral edema.

The mortality rate of patients with massive abdominal dropsy reaches 50%. Measures that prevent the occurrence of this pathological condition consist in the timely treatment of infectious and inflammatory processes, proper nutrition, refusal to drink alcohol, moderate sports, preventive examinations of medical specialists and the exact implementation of their recommendations.