Diagnostic Approach of Patient with Ascites: A Case Report

Ascites is an accumulation of fluid in the peritoneal cavity due to increase of capillary permeability, portal venous pressure, oncotic pressure, or lymphatic obstruction. From all the pathophysiological mechanisms mentioned, about 80 % of the cases occur due to increased portal venous pressure (portal hypertension). It has been known that portal hypertension is associated with chronic liver disease (CLD). Nevertheless, ascites can also be found in several diseases such as kidney disease, heart disease, infection, malignancy or others. Determining the underlying disease of ascites is a challenge for the clinician, anamnesis including the course of the disease, risk factors, comorbidities are needed to be done properly. Ascites usually accompanied by other symptoms, for example in liver disease (signs of portal hypertension), kidney disease (anasarca), heart failure (increased jugular venous pressure, murmurs, gallops), and malignancies (mass, lymphadenopathy), thus physical examination should be performed in every patient carefully. In minimal amount of fluid, abdominal ultrasonography (USG) are recommended. Furthermore, it is good at detecting organomegaly or mass. This study will discuss the diagnostic approach of patients with ascites in the form of case report and literature review.