복수, 간신증후군 및 자발성 세균성 복막염Ascites, Hepatorenal Syndrome and Spontaneous Bacterial Peritonitis in Patients with Portal Hypertension
- Other Titles
- Ascites, Hepatorenal Syndrome and Spontaneous Bacterial Peritonitis in Patients with Portal Hypertension
- Authors
- 김영석
- Issue Date
- 2010
- Publisher
- 대한소화기학회
- Keywords
- Ascites; Hepatorenal syndrome; Peritonitis; Hypertension; Portal
- Citation
- 대한소화기학회지, v.56, no.3, pp 168 - 185
- Pages
- 18
- Journal Title
- 대한소화기학회지
- Volume
- 56
- Number
- 3
- Start Page
- 168
- End Page
- 185
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/18281
- ISSN
- 1598-9992
2233-6869
- Abstract
- Ascites, hepatic encephalopathy and variceal hemorrhage are three major complications of portal hypertension. The diagnostic evaluation of ascites involves an assessment of its etiology by determining the serum-ascites albumin gradient and the exclusion of spontaneous bacterial peritonitis. Ascites is primarily related to an inability to excrete an adequate amount of sodium into urine, leading to a positive sodium balance. Sodium restriction and diuretic therapy are keys of ascites control. But, with the case of refractory ascites, large volume paracentesis and transjugular portosystemic shunts are required. In hepatorenal syndrome, splanchnic vasodilatation with reduction in effective arterial volume causes intense renal vasoconstriction. Splanchnic and/or peripheral vasoconstrictors with albumin infusion, and renal replacement therapy are only bridging therapy. Liver transplantation is the only definitive modality of improving the long term prognosis.
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