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Ascites and spontaneous bacterial peritonitis: an Asian perspective

Authors
 Jung Min Lee  ;  Kwang-Hyub Han  ;  Sang Hoon Ahn 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.24(9) : 1494-1503, 2009 
Journal Title
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 
ISSN
 0815-9319 
Issue Date
2009
MeSH
Ascites/diagnosis ; Ascites/epidemiology ; Ascites/etiology* ; Ascites/therapy ; Asia/epidemiology ; Combined Modality Therapy ; Disease Progression ; Humans ; Liver Cirrhosis/complications* ; Liver Cirrhosis/epidemiology ; Liver Cirrhosis/therapy ; Peritonitis/diagnosis ; Peritonitis/epidemiology ; Peritonitis/etiology* ; Peritonitis/microbiology ; Peritonitis/therapy ; Predictive Value of Tests ; Severity of Illness Index ; Treatment Outcome
Keywords
ascites ; Asian perspective ; cirrhosis ; spontaneous bacterial peritonitis
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
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2009.06020.x/abstract
DOI
10.1111/j.1440-1746.2009.06020.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Jung Min(이중민)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104922
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