Management of the patient with ascites.

Major factors in the development of ascites in the setting of chronic liver disease include portal hypertension and a reduction in plasma oncotic pressure (hypoalbuminemia). Diagnostic paracentesis is indicated on initial presentation of the patient with ascites, when the amount of fluid increases notably, or when the patient's condition suddenly deteriorates. In the management of ascites, attempts should be made to improve the underlying liver disease, and sodium and fluid intake should be restricted. The peritoneovenous shunt is occasionally used to treat intractable ascites.