Ascites is a common complication of liver cirrhosis and is associated with a poor prognosis. The main pathophysiology is an increased portal pressure with compensatory activation of neurohumoral systems. A patient history, proper physical exam and adequate examination of ascitic fluid will reveal the aetiology in most cases. Complications such as spontaneous bacterial peritonitis and thrombosis of hepatic vessel should be excluded in cases of first episode of ascites or deterioration of ascites. A moderate salt restriction and treatment with diuretics is the mainstay of treatment. Potentially nephrotoxic drugs such as NSAID and ACE inhibitors should be avoided in patients with cirrhosis.
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