Perihepatic Ascites Causes and Symptoms

Updated on 2 Jul 2020

Everyone wants better health and improved quality of life but there are some medical conditions that can adversely affect this goal. Some can be a serious illness or injury while some can be a minor concern that can be addressed by some home remedies. One of the most important organs of the body is the liver and if the said organ is affected, it is considered a major blow to the health of the individual. Liver disease can lead to a condition known as ascites. But what does it perihepatic ascites mean and what are its possible causes and symptoms? In this article, we will try to answer these questions so read on and find out more!

Perihepatic Ascites: A Brief Overview

Ascites is when more than 25 ml (millimeters) of fluid accumulate in the abdomen. This is also referred to as perihepatic ascites which means ascites around the area of the liver or the peritoneal cavity. Perihepatic ascites occurs due to the liver no longer properly functioning. Once this kind of malfunction happens, the space in between the organs and the lining of the abdomen can get filled up with fluid. Clinical guidelines that were issued in 2010 in a journal focused on hepatology, the rate of survival for patients afflicted with ascites is 50% within two (2) years. As such, individuals are advised to immediately consult with their healthcare professional if they observe or experience any symptoms of ascites.

Ascites are most commonly the result of scarring of the liver also referred to as cirrhosis. A liver that is scarred has increased pressure inside its blood vessels. This increased pressure can then have the fluids forced into the cavity of the abdomen which can then lead to the development of ascites. The risk factors for the development of ascites all revolve around damage to the liver. These include alcohol abuse for long periods of time, hepatitis B or C, and cirrhosis.

Some of the other factors that can increase the likelihood of ascites occurring are hypothyroidism, tuberculosis, pancreatitis, kidney failure, heart failure, cancer of the liver, pancreas, and the ovary.

Ascites: When should a Doctor Be Consulted?

Ascites symptoms can appear either suddenly or slowly and will all depend on the cause of the buildup of fluid. These symptoms will not usually indicate something urgent or should they be considered as an emergency.

Patients are advised to talk to their doctor for any of the following issues:

Heartburn
Vomiting and nausea
Bloating
Pain in the abdomen
An appetite that is diminished
Difficulty breathing
Weight gain that is sudden
An abdomen that is swollen or distended.

It must be noted though that these conditions may also be the symptoms of other health conditions and not just ascites.

The doctor will then diagnose if the patient really has ascites through a number of different stages or steps. The healthcare professional will first verify the patient’s abdominal swelling. Next, the medical practitioner may require the use of another method for testing or some imaging tests to check for the buildup or accumulation of fluid. Some of these tests may include angiography, laparoscopy, blood tests, MRI, CT scan, and ultrasound.

Treatment Options for Ascites

Treating Ascites will depend mostly on the cause of the health condition in the first place. Listed below are some of the possible treatment options for ascites:

Diuretics- These are usually utilized to have ascites treated and are regarded as one of the most effective treatments of choice for individuals suffering from the aforementioned medical issue. Diuretics can help elevate the levels of water and salt that leave the individual’s body which can then lead to the reduction of pressure within the liver’s surrounding veins. While individuals are taking diuretics, the healthcare professional may require the regular monitoring of the patients’ blood chemistry. In addition, patients will have to ensure a reduction in the intake of alcohol along with their consumption of salt and other salty food items.
Paracentesis- For this medical procedure, a needle that is thin and long will be utilized in the removal of the excess fluid. The needle shall be inserted through the skin and into the cavity of the abdomen. The infection risk for this kind of procedure is present and may occur. As such, people who choose to avail of this specific treatment may be given or prescribed with antibiotics to prevent any incidence of infection. Paracentesis is the treatment of choice for patients whose ascites are considered recurrent or severe. This is because, for such cases, diuretics don’t work as well as paracentesis.
Surgery- In cases that are considered extreme, a tube is implanted permanently on the patient’s body. This is referred to as a shunt and can aid in the rerouting of the flow of the blood around the perihepatic area. Another surgical procedure that may be recommended by the doctor is a transplant of the liver. This is done when the ascites do not respond as expected to the aforementioned treatment options. Liver transplant is an option considered for people who already have end-stage liver disease.

Possible Ascites Complications

Ascites can also have complications such as:

Hepatorenal Syndrome– A kidney failure that is rare and is progressive
Infection by bacteria– An example of this is SBP or spontaneous bacterial peritonitis
Hernias– An example of this is an inguinal hernia
Pleural effusion– Also referred to as water on the lung and can lead to breathing difficulties
Pain in the abdomen– usually caused by the increasing pressure of ascites on the abdominal cavity. This can also have other symptoms linked to it such as shortness of breath and bloating.

Bottom Line

The bottom line is that the prevention of ascites cannot be guaranteed 100%. However, people can still lower their risk factors through the protection of the liver. Some healthy habits that can help include: