Malignant ascites is the buildup of large volumes of fluid in the peritoneal cavity secondary to cancer. Management of ascites due to gastrointestinal malignancy. Management of ascites due to gastrointestinal malignancy ncbi. Management of ascites in ovarian cancer patients rcog. Paracentesis is indicated for those patients who have symptoms of increasing intraabdominal pressure. Women with malignant ascites who had a confirmed histological diagnosis of gynaecological cancer cancer of the body of uterus, vaginafallopian tube, ovary, vulva and whose drainage was managed in hospital.
Current and future options in the treatment of malignant ascites in. Pdf management of ascites due to gastrointestinal malignancy. Management of ascites in ovarian cancer patients 1. The development of malignant ascites carries a poor prognosis, with the median survival reported anywhere between 1 and 4 months. In the absence of malignancy, liver disease is responsible for over 80% of cases of ascites. Current treatment options behrendt, r robert wood johnson university hospital, new brunswick, nj. Cancers commonly associated with the development of ascites include breast, colorectal, endometrial, gastric, ovarian and pancreatic cancer. Malignant ascites is a sign of peritoneal carcinomatosis, the presence. Malignant ascites current medical diagnosis and treatment 2020. While the pathophysiology of malignant ascites is not totally understood, factors that contribute to the development of ascites include lymphatic obstruction by tumor cells, excess vascular permeability, and hormonal effects, as well as other tumorspecific effects such as excess metalloproteinase production. Introduction malignant ascites is the buildup of large volumes of fluid in the peritoneal cavity secondary to cancer. Bsg guidelines on the management of ascites in cirrhosis 302.
Upon closer examination of the abdomen, patients with malignant ascites may have increased dullness to percussion or shifting dullness. In a survey of practice measures for managing malignant ascites, it was. Guidelines for the management of malignant ascites. Twothirds of cases of malignant ascites are caused by peritoneal carcinomatosis. Management should be aimed at maximising patient comfort and quality of life. About 1550% of patients with malignancy will develop ascites. Typical symptoms such as abdominal pain, nausea and dyspnea reduce quality of life. Women with cervical cancer were not included as they rarely develop malignant ascites. Exudative or transudative ascities on the basis of total protein content. Bsg guidelines on the management of ascites in cirrhosis. Background malignancy is the underlying cause in approximately 10% of all cases of ascites. Management options include diuretic therapy, therapeutic paracentesis and peritoneovenous shunts. Paracentesis is indicated for those patients who have symptoms of.
The most common tumors causing carcinomatosis are primary. Malignant ascites is the abnormal accumulation of fluid in the peritoneal cavity associated with several intrapelvic and intraabdominal. The management of malignant ascites in palliative care. A recommendation for further research is a randomized controlled trial comparing the use of diuretics with paracentesis in the management of malignant ascites. The current and future management of malignant ascites. There have been several changes in the clinical management of cirrhotic ascites over recent years, and the purpose of these guidelines is to promote a consistent clinical practice throughout the uk. Ascitic fluid analysis is essential for the diagnosis of malignant ascites. Routinely, a cell count and differential should be performed on ascitic. Malignant ascites current treatment and novel therapeutic options. An audit of clinical practice and development of standards and guidelines. Old and new drugs for the medical management of malignant ascites. Guidelines in the management of symptomatic malignant ascites in advanced cancer.
Management of malignant ascites is by drainage, rarely by diuretic therapy and. Barni s, cabiddu m, ghilardi m, petrelli f 2011 a novel perspective for an orphan problem. As a supportive treatment, ascites can be drained by paracentesis pc. In this study, different treatment options for malignant ascites due to ovarian. In most cases of malignancyrelated ascites, the prognosis is poor and treatment of. The use of diuretics should be considered in all patients, but has to be evaluated individually.
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