Ascites
Formal Definition
Accumulation of fluid in the peritoneal cavity, typically due to liver cirrhosis, malignancy, heart failure, or nephrotic syndrome.
How It's Used on the Ward
"She has ascites" — often called a "belly full of fluid" informally. "Tap the ascites" = paracentesis.
Example
""Cirrhotic patient with tense ascites: abdomen distended, fluid wave present, shifting dullness on exam. SAAG from the tap was 1.2, consistent with portal hypertension.""
Clinical Context
SAAG (serum-ascites albumin gradient) ≥1.1 = portal hypertension cause (cirrhosis, heart failure, Budd-Chiari). <1.1 = non-portal cause (malignancy, TB, pancreatitis). Diagnostic paracentesis should always be sent for cell count, albumin, protein, and culture.
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