ASCITE PARACENTESE PDF

La cirrhose du foie se classe en principe en trois stades score Child-Pugh. En fonction du total des points, il y a le stade A bon pronostic et les stades B et C mauvais pronostic. If there is the slightest suspicion of spontaneous bacterial peritonitis, bacteriological assessment in blood culture vials of the ascites fluid should be done. In therapy-resistant ascites the treatment of choice is forced diuretic therapy up to mg spironolactone plus mg furosemide per day or paracentesis.

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La cirrhose du foie se classe en principe en trois stades score Child-Pugh. En fonction du total des points, il y a le stade A bon pronostic et les stades B et C mauvais pronostic. If there is the slightest suspicion of spontaneous bacterial peritonitis, bacteriological assessment in blood culture vials of the ascites fluid should be done.

In therapy-resistant ascites the treatment of choice is forced diuretic therapy up to mg spironolactone plus mg furosemide per day or paracentesis. If this fails to produce a result over a prolonged period, a transjugular intrahepatic portosystemic shunt TIPS may be considered. Tableau 1. In this situation timely recognition and swift therapeutic action are essential in lowering mortality.

Hence this is the moment for the attending physician to refer the patient to a liver transplantation centre to evaluate to the possibility of a liver transplantation, provided no obvious contraindications are present.

Ascite Tableau 2. Tableau 3. Il y a plusieurs options pour la traiter. Leading causes for National vital statistics reports. A prognostic model for predicting survival in cirrhosis with ascites.

J Hepatol ;— Pathogenesis of ascites in cirrhosis. Sem in Liver Dis ;— Hepatology ;— Management of cirrhosis and ascites. NEJM ;— Spironolactone alone or in combination with furosemide in treatment of moderate ascites in nonazotemic cirrhosis: A randomised comparative study of efficacy and safety. The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club.

Diuretic requirement after therapeutic paracentesis in non-azotemic patients with cirrhosis: A randomised double-blind trial of spironolactone versus placebo. J Hepatol ; —20 Erratum.

J Hepatol ; Definition and diagnostic criteria of refrectory ascites and hepatorenal syndrome in cirrhosis. Gastroenterology ;— Renal impairment after spontaneous bacterial peritonitis in cirrhosis: Incidence, clinical course, predictive factors and prognosis.

Terlipressin plus albumin infusion: an effective and safe therapy of hepatorenal syndrome. J Hepatol ;—8. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: A consensus document.

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Infection au site de ponction. Le point de ponction se situe entre le tiers externe et le tiers moyen de cette ligne. Pannicule adipeux important Les Venflons sont parfois trop courts. Perforation de la vessie Anecdotique. The serum-ascites albumin gradient is superior to the exsudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med ;

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