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Principles Of Management Of Ascites Combined

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PRINCIPLES OF MANAGEMENT OF ASCITES Richard Warner
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Causes of Ascites- Normal Peritoneum SAAG >11g/l ,[object Object],[object Object],[object Object],[object Object]
Causes of Ascites- Normal Peritoneum SAAG >11g/l ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Ascites- Normal Peritoneum SAAG >11g/l ,[object Object],[object Object],[object Object],[object Object]
Causes of Ascites- Normal Peritoneum SAAG < 11g/l ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Ascites- Diseased Peritoneum SAAG < 11g/l ,[object Object]
Causes of Ascites- Diseased Peritoneum SAAG < 11g/l ,[object Object],[object Object]
 
 
Ascites is not just a Cosmetic Problem ! ,[object Object],[object Object],[object Object],[object Object]
Management of Ascites- Guidelines ,[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object]
Treatment Options ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ascites- Grading ,[object Object],[object Object],[object Object],[object Object]
Management of ascites- Bed Rest ,[object Object],[object Object]
Management of ascites- Sodium Restriction ,[object Object],[object Object],[object Object],[object Object],[object Object]
MANAGEMENT OF ASCITES- Salt restriction (cont) ,[object Object],[object Object]
MANAGEMENT OF ASCITES- WATER RESTRICTION ,[object Object],[object Object],[object Object],[object Object]
MANAGEMENT OF ASCITES- DIURETICS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ASCITES- Assess response to diuretics : ,[object Object],[object Object],[object Object]
Ascites- Paracentesis ,[object Object],[object Object]
Ascites- Paracentesis ,[object Object],[object Object],[object Object]
Paracentesis- Systemic Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Paracentesis ,[object Object],[object Object],[object Object]
Ascites- Refractory Ascites ,[object Object],[object Object],[object Object]
Refractory Ascites- Treatment Options ,[object Object],[object Object],[object Object],[object Object]
Refractory Ascites- Treatment Options ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Refractory Ascites- Treatment Options ,[object Object],[object Object],[object Object],[object Object]
 
 
Refractory Ascites- Treatment Options ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Refractory Ascites- Treatment Options ,[object Object]
TIPSS ,[object Object],[object Object],[object Object],[object Object]
 
TIPS vs. Paracentesis 58% vs.48 % 69% vs. 52% 61% vs.18% p=.006 60 Rossle et al NEJM, 2000 55% vs. 46% 71% vs. 35% 74% vs.35% p=.008 57 Salerno et al Hepatology 2002 38% vs. 12% 40% vs. 37% 58% vs. 16% p<.001 109 Sanyal et al Gastroenterology 2003 60% vs. 34% 41% vs. 35% 51% vs. 17% p=.003 70 Gines et al Gastroenterology, 2002 Encephalopathy Survival 1 Year Control of Ascites No. Patients Study
TIPS- Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ASCITES MX ,[object Object],[object Object],[object Object],[object Object],[object Object]
Any Questions?
TIPS VS PARACENTESIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TIPS VS PARACENTEISIS ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Principles Of Management Of Ascites Combined

  • 1. PRINCIPLES OF MANAGEMENT OF ASCITES Richard Warner
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  • 36. TIPS vs. Paracentesis 58% vs.48 % 69% vs. 52% 61% vs.18% p=.006 60 Rossle et al NEJM, 2000 55% vs. 46% 71% vs. 35% 74% vs.35% p=.008 57 Salerno et al Hepatology 2002 38% vs. 12% 40% vs. 37% 58% vs. 16% p<.001 109 Sanyal et al Gastroenterology 2003 60% vs. 34% 41% vs. 35% 51% vs. 17% p=.003 70 Gines et al Gastroenterology, 2002 Encephalopathy Survival 1 Year Control of Ascites No. Patients Study
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