Ascites in childhood liver disease.

Simple item page
dc.contributor.authorYachha, Surender Kumaren_US
dc.contributor.authorKhanna, Vikranten_US
dc.date.accessioned2006-09-29en_US
dc.date.accessioned2009-05-30T10:37:28Z
dc.date.available2006-09-29en_US
dc.date.available2009-05-30T10:37:28Z
dc.date.issued2006-09-29en_US
dc.description17 references.en_US
dc.description.abstractAscites is a common clinical problem in children with liver disease. The peripheral arterial vasodilation hypothesis is mostly accepted as the pathophysiological basis of ascites. The most important complication is spontaneous ascitic fluid infection in the form of spontaneous bacterial peritonitis (SBP) and its variants. Aerobic gram-negative bacteria, primarily Escherichia coli, are the most common isolates. Diagnostic paracentesis is done in patients with ascites when diagnosed first time and at the beginning of each admission to hospital. Ascitic fluid is evaluated for cell count with differential, albumin level, total protein and culture. Serum-ascites albumin gradient (SAAG) is the best single test for classifying ascites into portal hypertensive (SAAG> 1.1 g/dL) and non-portal hypertensive (SAAG < 1.1 g/dL) causes. In patients with tense ascites LVP should be performed. A neutrophil count of > 250 cells/mm3 is highly suggestive of bacterial peritonitis. Intravenous cefotaxime is the empiric antibiotic of choice. Long-term administration of oral norfloxacin 5-7.5 mg/Kg once a day in cirrhotic patients with ascitic fluid protein content of < 1g/dL or prior episode of SBP is recommended for prevention of SBP. Oral dual diuretic therapy of single morning dose of spironolactone along with furosemide in the ratio of 5:2 is recommended. While obtaining satisfactory diuretic response dual diuretic therapy can be changed over to monotherapy with spironolactone. Patients should be on sodium restricted diet. Management of ascites might ultimately require liver transplantation.en_US
dc.description.affiliationDepartment of Gastroenterology (Pediatric Gastroenterology), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow - 226 014, India. skyachha@sgpgi.ac.inen_US
dc.identifier.citationYachha SK, Khanna V. Ascites in childhood liver disease. Indian Journal of Pediatrics. 2006 Sep; 73(9): 819-24en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/78838
dc.language.isoengen_US
dc.source.urihttps://medind.nic.in/icb/icbai.shtmlen_US
dc.subject.meshAscites --complicationsen_US
dc.subject.meshAscitic Fluid --chemistryen_US
dc.subject.meshBacterial Infections --etiologyen_US
dc.subject.meshChilden_US
dc.subject.meshHumansen_US
dc.subject.meshLiver Diseases --complicationsen_US
dc.subject.meshPeritonitis --microbiologyen_US
dc.titleAscites in childhood liver disease.en_US
dc.typeJournal Articleen_US
dc.typeReviewen_US
Files
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.79 KB
Format:
Plain Text
Description:
Download
Collections
Indian Journal of Pediatrics