Paracentesis peritoneal es una punción quirúrgica de la cavidad peritoneal para la aspiración de ascitis, término que denota la acumulación. que se insertará el instrumento de paracentesis; Condición abdominal severa . La paracentesis sin embargo no está libre de complicaciones, por lo que es particularmente importante dar coloides como reemplazo, para prevenirla.

Author: Akibei Meztilrajas
Country: Bahamas
Language: English (Spanish)
Genre: Literature
Published (Last): 14 April 2011
Pages: 49
PDF File Size: 3.17 Mb
ePub File Size: 1.73 Mb
ISBN: 872-3-30130-291-5
Downloads: 6331
Price: Free* [*Free Regsitration Required]
Uploader: Vudogar

Pleurodesis and surgical repair of diaphragmatic defects is often unsuccessful and fraught with serious complications. Hepatology 8, Conflict of interests The authors declare no conflict of interest. Severe symptoms such as fits, vomitingconfusion and ataxia or very severe hyponatraemia requires treatment in an intensive care unit owing to the risks of respiratory arrest. As would expected, impaired free water clearance is associated with hyponatraemia and a poor prognosis Table 2.

[Paracentesis as abdominal decompression therapy in neuroblastoma MS with massive hepatomegaly].

Gynaecomastia, often painful, is the most troublesome side-effect and when it occurs sodium canrenoate which has a similar diuretic action can be used. At today, the main indications for TIPS are: Local diseases in paracetnesis peritoneal cavity such as TB, malignant disease,and pancreatitis, damage capillaries and produce protein-rich ascites exudates.

They produce a diuresis starting 6 hours and ending 24 hours after administration, and are usually used to potentiate loop diuretics and reduce urinary paracentseis loss.

Nevertheless, the risk of hepatic encephalopathy is still high and constitutes one of the most important limit to a larger use of TIPS. Royal Infirmary of Edinburgh ocmplicaciones the Department of Medicine. Furthermore, the ascites protein may rise during diuretic therapy Hoefs Total paracentesis associated with intravenous albumin management complicacionees patients with cirrhosis and ascites.

  6SE6440-2UD21-1AA1 MANUAL PDF

Moreover, patients with cirrhosis and ascites are frequentely complicated by acute episode of bacterial infection. Mean survival is shorter in patients who develop PPCD compared to those who do not. The mechanismofascicfiuid protein concentration during diuresis in patients with chronic liver disease. Ascites not attributed to cirrhosis is usually due to intra-abdominal malignant disease and other causes are uncommon Table 6. Key words cirrhotic cardiomyopathy, ascites, hyperdynamic circulation.

Albumin solution is perhaps the most effective, but it is also the most expensive Table 9.

Paracentesis, however, is not without complications, and it is particularly important to give colloid replacement to prevent hypovolaemia which can lead to renal failure. Uncontrolled trials have shown that full or partial resolution of ascites follows a TIPPS in three quarters more of patients but hepatic encephalopathy appears for the first time in about a fifth, the need for diuretic treatment continues, and a half to two thirds of patients die within two years Ochs et alMartinet et al However, in a series of procedures, De Gottardi et al.

Indeed, Gines et al. Bacterial culture should be carried out by innoculating ascitic fluid into blood culture bottles as this gives the highest yield of bacteria Runyon et al EASL clinical practice guidelines on thev management of ascites, spontaneous bacterial paracentesie, and hepatorenal syndrome I in cirrhosis.

Features indicating general susceptibility to infection include poor reticuloendothelial activity, reduced complement activy and impaired leucocyte function.

Serum-ascites albumin concentration gradient: Mechanism and Effect on Hepatic Hemodynamics in Cirrhosis. To prevent PPCD an infusion of human albumin at the dose of 7—8 g per liter of fluid tapped is highly recommended.

[Paracentesis as abdominal decompression therapy in neuroblastoma MS with massive hepatomegaly].

This is done most safely by measuring the wedged hepatic venous pressure. Recurrence of SBP after recovery is common and occurs in about two thirds of patients within a year and in three quarters within two years Tao et al; Natural history and prognostic indicators of survival in cirrhosis: Rarely, measurement of the portal venous pressure may reveal otherwise occult hepatic cirrhosis by revealing portal hypertension.


Aminoglycosides were used previously but are now avoided owing to their renal toxicity. To improve our services and products, we use “cookies” own or third parties authorized to show advertising related to client preferences through the analyses of navigation customer behavior.

This procedure causes a fall of portal pressure with reduction of the vascular collateral circulation. The ascites amylase is high in pancreatic ascites and should be measured particularly when the protein content of ascites is high. This emphasises the need to consider liver transpiantation in refractory ascites but where this is inappropriate TIPPS should be used particularly in Child B patients where liver funtion is better.

Liver Int, 30pp. Ultrasonography is particularly useful in identifying small amounts of ascites as it can detect as little as mI of free peritoneal fluid Goldberg et aland in such cases it allows the aspiration of fluid for analysis.

The treatment of hepatic hydrothorax is difficult and paracentesia unsuccessful. Bloody ascites can be due to trauma caused by liver biopsy, fine-needle complidaciones, TIPPS insertion or, rarely, paracentesis. Thoracentesis gives immediate relief from dyspnoca but usually only has a transient effect with repeated treatments eeded up to weekly.

J Hepatol, 58pp. Early use of TIPS in patients with cirrhosis and variceal bleeding.