When should I call my doctor about ascites?
How is ascites diagnosed?
Diagnosis of underlying condition causing ascites is the most important part of understanding the reason for a person to develop ascites. The medical history may provide clues to the underlying cause and typically includes questions about previous diagnosis of liver disease, viral hepatitis infection and its risk factors, alcohol abuse, family history of liver disease, heart failure, cancer history, and medication history.
Blood work can play an essential role in evaluating the cause of ascites. A complete metabolic panel can detect patterns of liver injury, functional status of the liver and kidney, and electrolyte levels. A complete blood count is also useful by providing clues to underlying conditions. Coagulation (clotting) panel abnormalities (prothrombin time) may be abnormal because of liver dysfunction and inadequate production of clotting proteins.
Sometimes the possible underlying causes of ascites may not be determined based on the history, examination, and review of laboratory data and imaging studies. Analysis of the fluid may be necessary in order to obtain further diagnostic data. This procedure is called paracentesis, and it is performed by trained physicians. It involves sterilizing an area on the abdomen and, with the guidance of ultrasound, inserting a needle into the abdominal cavity and withdrawing fluid for further analysis.
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