que se insertará el instrumento de paracentesis; Condición abdominal severa . Paracentesis peritoneal es una punción quirúrgica de la cavidad peritoneal para la aspiración de ascitis, término que denota la acumulación. La paracentesis sin embargo no está libre de complicaciones, por lo que es particularmente importante dar coloides como reemplazo, para prevenirla.

Author: Kigajas Daigal
Country: Congo
Language: English (Spanish)
Genre: Sex
Published (Last): 26 January 2017
Pages: 398
PDF File Size: 9.52 Mb
ePub File Size: 7.36 Mb
ISBN: 721-8-77178-689-6
Downloads: 56291
Price: Free* [*Free Regsitration Required]
Uploader: Kajizilkree

Three general theories have been proposed to explain renal retention of sodium in hepatic cirrhosis Ring-Larsen and Henriksen, In short, TIPSS can improve refractory ascites but the mortality is not improved and may even be increased, especially in Child C patients where liver function is very poor.

Rarely, measurement of the portal parscentesis pressure may reveal otherwise occult hepatic cirrhosis by revealing portal hypertension.

Para enviar un comentario, por favor complete el siguiente formulario. El reservorio tiene una cubierta de silicona que puede ser perforada con una aguja especial. This is done most safely by measuring the wedged hepatic venous pressure.

Puertas peritoneales

They act by inhibiting sodium and chloride absorption in the distal tubule and cause increased secretion of potassium by the distal tubules. B ile-stained paracentseis points to a biliary communication usually caused by gallstones, neoplasia or trauma.

Pleural effusion and hydrothorax can also occur below.

Complicackones produce a diuresis starting 6 hours and ending 24 hours after administration, and are usually used to potentiate loop diuretics and reduce urinary potassium loss. Norfloxacin is a poorly absorbed quinolone which reduces the aerobic Gram negative gut flora without suppressing the anaerobic flora and it has proved successful in reducing recurrance of SBP. Before diagnosing refractory ascites it is important to exclude unrecognised inappropriate sodium intake, failure to take diuretic drugs concomitant drug therapy causing sodium retention above and ascites complixaciones to causes other than cirrhosis Table 6 even in a patient with cirrhosis.


Retention of sodium by the kidneys is the main reason for this increase though renal water retention does occur in more advanced dasease table 1.

Diastolic dysfunction is frequently detected in this setting and heart structural changes are being characterized. This source needs to be identified and excluded.

[Paracentesis as abdominal decompression therapy in neuroblastoma MS with massive hepatomegaly].

Bacterial culture should be carried out by innoculating ascitic fluid into blood culture bottles as this gives the highest yield of bacteria Runyon et al The clinical features are those of cough, dyspnoea, chest pain or fever in a patient with a pleural effusion, of an associated spontaneous bacterial peritonitis, or of unexplained deterioration in a patients condition.

Pleurodesis and surgical repair of diaphragmatic defects is often unsuccessful and fraught with serious complications.

The successful treatment of symptomatic, refractory hepatic hydrothorax with transjugular intrahepatic portosystemic shunt. Hepatic cirrhosis is the most common cause of ascites. Albumin solution is perhaps the most effective, but it is also the most expensive Table 9.

Paracentesis Abdominal

A randomized double-blind trial of spironolactone versus placebo. El sito debe ser inspeccionado cuidadosamente cada vez que se cambia la ropa. Se aconseja programar que un familiar o un amigo pzracentesis lleve a su hogar una vez concluido el procedimiento. The development of uraemia is a serious prognostic sign.

Hepatology 5, Journal of Hepatology, 26, Spontaneous Bacterial Peritonitis in cirrhosis: One suggests that portal hypertension causes a loss of fluid into the peritoneun and leads to depletion of the intravascular volume underfilling theory with secondary and compensatory renal retention of sodium and water; another suggests that the fiver disease itself causes primary renal sodium and water retention leading to expansion of the vascular volume and hence the ascites overflow theory ; a third theory proposes a primary circulatory derangement resulting in a reduced effective arterial plasma volume with consequent renal retention of sodium and water Henriksen et al Total paracentesis of all ascites reduces the wedged hepatic venous pressure and recently it has been reported also to decrease intravariceal pressure Kravetz et al The accuracy of the physical examination in the diagnosis of suspected ascites.

  AOCS CE 2-66 PDF

Infection is a very serious complication of ascites spontaneous bacterial peritonitis and carries a generally poor prognosis. Seminars in Liver Disease 6,Bacteria probably reach the ascitic fluid as a result of bacteraemia, and as a high proportion of ascitic infections are with gut-related organisms, many must reach the blood by passing through the bowel wall.

El riesgo es menor si usted sigue cuidadosamente las instrucciones para el cuidado de las incisiones mientras cicatrizan. Accordingly, preventative measures to support the circulation with a colloidal solution at the time of paracentesis are important as this prevents circulatory dysfunction. Medicine 50, Hepatology 3, The supra-additive natriuretic effect additional of quinethazone or bendrofflumethiazide during long-term treatment with furosemide and spironolactone.

Patients requiring this treatment have advanced disease and encephalopathy and deterioration of fiver function can occur fter TIPSS. The knowledge of subtle cardiostructural changes that can be detected even in complicacionees early stages of preascitic cirrhosis have contributed to a better understanding of the cardiovascular derangement observed as disease severity progresses.