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Colegio de Medicina Interna de México.

2022, Número 6

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Med Int Mex 2022; 38 (6)


Ascitis: fisiopatología, diagnóstico y tratamiento

Vidal-González D, Moreno-Madrigal LG, Pérez-López KP, Vera-Nungaray SA

Idioma: Español
Referencias bibliográficas: 50
Paginas: 1223-1232
Archivo PDF: 215.67 Kb.


RESUMEN

La ascitis es la acumulación de líquido en la cavidad peritoneal, causada por una amplia variedad de afecciones, la más común es la cirrosis hepática. En estos pacientes, la aparición de ascitis es consecuencia de vasodilatación esplácnica, disminución en el volumen circulante efectivo y activación del sistema nervioso simpático y el sistema renina angiotensina-aldosterona, además de un proceso inflamatorio sistémico. El abordaje diagnóstico incluye, además de datos clínicos sugerentes de ascitis y de sus causas específicas, estudios de imagen (el ultrasonido abdominal es el método inicial de elección, que puede complementarse con tomografía computada o estudios de imagen por resonancia magnética) y de laboratorio, como el gradiente de albúmina sérica-ascítica (que permite la distinción entre causas relacionadas con hipertensión portal versus oncológicas, infecciosas y otras inflamatorias, síndrome nefrótico, etc.), tinciones, cultivos y citología, entre otros. Algunos biomarcadores moleculares están en investigación. El manejo es diverso y depende de la causa específica.


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