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Gastroenterology clinic

Managing fluid retention in cirrhosis

Uthayanan Chelvaratnam, Katherine Stuart

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Abstract

Fluid retention in cirrhosis, which most often manifests as ascites, is associated with a poor prognosis. All patients who develop ascites should be referred for specialist hepatology input.

Key Points

    Remember
  • Ascites is the most common complication of cirrhosis (Figure 1), affecting 60% of patients over a 10-year period.
  • The presence of ascites is a sign of liver failure and is associated with a five-year mortality of 30%.2 Hepatic encephalopathy and variceal haemorrhage are other signs of liver failure.
  • Signs of fluid retention that are less often observed in patients with cirrhosis include peripheral oedema and hepatic hydrothorax (5 to 10%) and are almost always observed in association with ascites. Hepatic hydrothorax is usually right-sided, but it can be left-sided or bilateral.

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