Gastroenterology clinic

Managing fluid retention in cirrhosis

Gastroenterology clinic

Managing fluid retention in cirrhosis

Uthayanan Chelvaratnam, Katherine Stuart

Figures

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.