How to Diagnose Ascites

Ascites is the medical term used to describe a condition where fluid builds up unexpectedly in the abdomen. Although it is most often attributed to a diseased liver, that is not the only medical condition that triggers it. Diseases such as cancer, heart, kidney or pancreatic disorders may lead to it as well as abdominal trauma, appendicitis, colon inflammation and infection.

Instructions

Diagnosing Liver-Related Ascites

• 1

  Check medical records for previous conditions like alcoholism, cholestasis, hepatitis, liver encephalopathy, or portal hypertension.

• 2

  Do a physical exam. Look for abdominal pain, edema, enlarged liver or spleen, fever, jaundice, mental confusion, unusual stool, signs of digestive tract bleeding, speech problems, swelling and urination issues.

• 3

  Ask the patient if he has bleeding gums, blood in vomit, decreased appetite, constipation, difficulty breathing, excessive indigestion, increased fatigue or drowsiness, rapid weight gain or loss, uncontrolled nose bleeds or unexplained itches. Also ascertain if he uses alcohol and, if so, how often.

• 4

  Run laboratory tests, checking for anemia, blood clot times, and elevated bilirubin, liver enzymes or serum albumin levels. Order a CT scan to check for signs of cancer; a doppler ultrasound to look for blood clots; an MRI to search for related diseases and an ultrasound to confirm fluid presence.

• 5

  Perform surgery. Laproscopic surgery offers a visual view of the condition. A biopsy can confirm the presence of liver cirrhosis.

Diagnosing Chylous Ascites

• 6

  Check medical records for previous diagnosis of anorexia, cancer, heart failure, hepatitis, tuberculosis or sexually transmitted diseases. These can be precursors of this form of ascites.

• 7

  Complete a physical exam. Look for anemia, changes in the skin or lymph glands, heart murmur, lung fluid, pain, signs of infection or internal bleeding, swelling, and venous or abdomen distension.

• 8

  Determine if the patient has constipation, decreased appetite, fatigue, flu-like symptoms, frequent heartburn or nausea. Also ascertain if he uses drugs or alcohol on a regular basis and how often.

• 9

  Run laboratory tests to check for elevated bilirubin, liver enzymes and albumin levels. Order abdominal and chest x-rays to look for underlying problems. Conduct a CT scan for signs of cancer and an ultrasound to confirm fluid retention.

• 10

  Complete a paracentesis to check for abnormally colored abdominal fluid. Fluid that is white in color like watered-down milk is a sign of chylous ascites.

  Complete a bacteria culture of the fluid collected.

• 11

  Perform surgery. Laproscopic surgery can provide a visual view of the problem.

Diagnosing Pancreatic Ascites

• 12

  Conduct a physical exam. Look for changes in gallbladder, liver, or pancreatic function, size, feel, and shape, skin jaundice and swelling.

• 13

  Find out if the patient has abdominal pain, appetite loss, excessive fatigue, trouble breathing, or weight loss.

• 14

  Run laboratory tests to check for elevated bilirubin. Conduct a CT or endoscopic ultrasound for pictures of the pancreas; an endoscopic retrograde cholangiopancreatography or percutaneous trashepatic cholangriography to review the functionality of the bile ducts; a ransabdominal ultrasound to show how the built-up fluid moves in the abdominal cavity; or a ultrasonography to check for tumors.

• 15

  Perform a needle biopsy to check for possible underlying disease like cancer.

• 16

  Perform laproscopic surgery.