Ascites and spontaneous bacterial peritonitis: An Asian perspective

Research output: Contribution to journalReview article

18 Citations (Scopus)

Abstract

Ascites is the most common complication of liver cirrhosis, and it develops as a consequence of portal hypertension and splanchnic vasodilatation. Depending on severity, management of ascites consists of diverse strategy, including dietary sodium restriction, diuretic therapy, repeated large-volume paracentesis with albumin infusion, transjugular intrahepatic portosystemic shunt, and liver transplantation. Recently, advances in medical therapy have been made with satavaptan, a V2 receptor antagonist, vasoconstrictors, such as clonidine, midodrine, or terlipressin, and other categories of drugs, including docarpamine and Chinese herbs. These drugs may serve as useful adjuncts to conventional diuretics in the management of ascites. Besides ascites itself, serious complications, such as spontaneous bacterial peritonitis (SBP) and hepatorenal syndrome, frequently ensue in decompensated cirrhosis. SBP develops from the translocation of bacteria from the intestine, and successful management with early diagnosis and treatment with proper prevention in patients of high risk is necessary. In summary, ascites is a starting point for more serious complications in liver cirrhosis. Although liver transplantation is the fundamental treatment, it is not always feasible, and consequently various means of treatment should be used. Further study, particularly in Asia where hepatitis B virus-related cirrhosis is predominant, is warranted to improve the clinical outcome.

Original languageEnglish
Pages (from-to)1494-1503
Number of pages10
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume24
Issue number9
DOIs
Publication statusPublished - 2009 Jan 1

Fingerprint

Peritonitis
Ascites
Diuretics
Liver Cirrhosis
Liver Transplantation
Fibrosis
Midodrine
Hepatorenal Syndrome
Transjugular Intrahepatic Portasystemic Shunt
Dietary Sodium
Paracentesis
Therapeutics
Vasopressin Receptors
Viscera
Clonidine
Portal Hypertension
Vasoconstrictor Agents
Hepatitis B virus
Vasodilation
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Gastroenterology
  • Hepatology

Cite this

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title = "Ascites and spontaneous bacterial peritonitis: An Asian perspective",
abstract = "Ascites is the most common complication of liver cirrhosis, and it develops as a consequence of portal hypertension and splanchnic vasodilatation. Depending on severity, management of ascites consists of diverse strategy, including dietary sodium restriction, diuretic therapy, repeated large-volume paracentesis with albumin infusion, transjugular intrahepatic portosystemic shunt, and liver transplantation. Recently, advances in medical therapy have been made with satavaptan, a V2 receptor antagonist, vasoconstrictors, such as clonidine, midodrine, or terlipressin, and other categories of drugs, including docarpamine and Chinese herbs. These drugs may serve as useful adjuncts to conventional diuretics in the management of ascites. Besides ascites itself, serious complications, such as spontaneous bacterial peritonitis (SBP) and hepatorenal syndrome, frequently ensue in decompensated cirrhosis. SBP develops from the translocation of bacteria from the intestine, and successful management with early diagnosis and treatment with proper prevention in patients of high risk is necessary. In summary, ascites is a starting point for more serious complications in liver cirrhosis. Although liver transplantation is the fundamental treatment, it is not always feasible, and consequently various means of treatment should be used. Further study, particularly in Asia where hepatitis B virus-related cirrhosis is predominant, is warranted to improve the clinical outcome.",
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Ascites and spontaneous bacterial peritonitis : An Asian perspective. / Lee, Jung Min; Han, KwangHyub; Ahn, SangHoon.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 24, No. 9, 01.01.2009, p. 1494-1503.

Research output: Contribution to journalReview article

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