Churchills Pocketbook of Differential Diagnosis

ASCITES 37
SPECIFIC INVESTIGATIONS
SUBASH KC/NMC-15TH/2014
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Echocardiography
Cardiac failure will manifest as a dilated and poorly contracting
ventricle with a reduced ejection fraction. A pericardial effusion
is visible as an echo-free space between the left ventricle and
the pericardium. Tricuspid regurgitation can be visualised with
colour-flow Doppler imaging.
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Liver biopsy
Will be able to confirm and may be able to ascertain the
underlying cause of liver cirrhosis.
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Renal biopsy
Reveals the underlying cause of nephrotic syndrome.
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Portal venography
Is indicated if obstruction to the venous outflow of the liver is
suspected and can confirm Budd–Chiari syndrome and venoocclusive
disease.
!
• Ascites can result from abnormalities in a number
of different systems and a detailed examination of
all systems is required to avoid missing potentially
treatable conditions, such as cardiac failure and TB.
Section A