Ascites is a medical condition which results when there is an imbalance between the plasma flow and the lymphatic drainage. Ascites is the buildup of fluid in the abdominal cavity which is beyond the normal fluid level present in the cavity. If you know what ascites is, then you already have an idea of malignant ascites. This condition is the accumulation of fluid in the abdominal cavity where the fluid in the cavity has cancerous cells in them and this is usually due to metastasis from a primary source of tumor in the body.
The most likely source of tumor that causes malignant ascites is tumors of the ovaries, uterus, pulmonary system, cervix, and gastrointestinal tract. Sometimes the tumors which cause malignant ascites are tumors of unknown primary origin. Patients who have this medical condition are usually patients in the last stage of metastasis (terminal stage of cancer).
The causes of this condition are numerous, it is often caused as a result of liver disease especially in patients who consume excess alcohol, or people that are drug abusers, using such drug intravenously, patients with hepatitis C, patients suffering from jaundice, people who have had blood transfusion or tattooing of their body.
Diagnosis of malignant ascites is usually done by patient’s complaints which include abdominal pain, bloated abdomen, Nausea and vomiting, feeling of fullness and lack of appetite. The physical examination also reveals a good ground for diagnosis because of the changes doctors find during palpation, percussion and auscultation of the abdomen. There are also different laboratory tests that are carried out; cell count which reveals increased number of white blood cells showing inflammation.
SAAG test which is used for diagnosis of portal hypertension. Neutrophil count is used to determine body action to fight against infection of bacterial origin and this is confirmed when it is elevated. Cytological smear is another means of diagnosis of malignant ascites although its accuracy is about 60-75 percent. The most reliable and effective diagnostic method for the diagnosis of malignant ascites is ultrasound.
When this condition is diagnosed treatment is carried out, although the treatment of malignant ascites is palliative, the aim of the doctor in the treatment is to make the patient feel better and eliminate the symptoms as much as possible.
Different treatments are available and one of such treatment is diuretic therapy, which is commonly used for ascites management. Patients who are best treated with this therapy are patients with hyponatremia (patients with reduced quantity of blood sodium.
Surgery is also used in the management of malignant ascites by draining the peritoneal fluid directly into the internal jugular vein. This method is results increased renal flow, increase in cardiac activity and increase in urine volume, promoting glomerular filteration, and decrease aldosterone level in plasma.
Also special diet is given to patients with malignant ascites, containing reduced quantity of sodium intake especially when sodium level is below 120mmol/L.
Malignant ascites is managed to relieve patient of the symptoms but cure of the condition is not yet possible because it results from a primary tumor in the body.
Source by Dave Morrison