Active substances: Norfloxacin
Share by Email How can I be sure that the patient has ascites? The most common cause of ascites is portal hypertension secondary to cirrhosis.
See Table I.
The main symptoms are increased abdominal girth with lower extremity edema. Dyspnea occurs as a consequence of increasing abdominal distention or due to pleural effusions.
Patients with ascites and spontaneous bacterial peritonitis SBP can present with fever, chills, abdominal pain, hepatic encephalopathy, and rebound abdominal tenderness.
However, only a minority of patients with SBP present with these symptoms. The diagnosis of SBP always requires an examination of the peritoneal fluid.
In addition to examining the patient for stigmata of chronic liver disease, a detailed physical exam needs to be performed.
Jugular venous distension can be seen in patients with heart failure. Anasarca can be associated with nephrotic syndrome and congestive heart failure. Firm lymphadenopathy is found in patients with an underlying malignancy.
Patients have to have at least 1500 mL of peritoneal fluid for ascites to be detected reliably by physical examination. Ultrasonography can detect as little as 100 mL of abdominal fluid and should be used for obese individuals and for patients in whom the physical examination is unreliable.
Shifting dullness also is a useful diagnostic maneuver. If ascites is present, percussion of the lateral aspect of the right flank demonstrates a shift in the location of the dullness when the patient is percussed in the supine, followed by the right lateral decubitus position.
How can I confirm the diagnosis? Diagnosis A diagnostic paracentesis of at least 30 mL should always be performed to elucidate the cause of ascites.
It should also be done in those patients requiring hospitalization and those with fever, abdominal pain, hypotension, or new onset hepatic encephalopathy.
The paracentesis should be done regardless of the INR international normalized ratio of the patient. Baseline tests that need to be ordered are cell count, culture in blood culture bottles, albumin, and protein.
Glucose, lactate dehydrogenase, amylase, bilirubin, triglyceride level, tuberculosis culture and smear, and cytology are optional and should be ordered if causes other than portal hypertension are considered.
The cell count is the most useful test because it determines the presence of infection. The difference between serum albumin and ascites albumin serum ascites-albumin gradient in patients with cirrhosis and portal hypertension is usually more than 1.
Values below 1. Patients with cirrhosis and a protein value below 1. An abdominal ultrasound with Doppler should be done to evaluate the liver parenchyma, rule out liver cancer or other masses, and evaluate the patency of the portal vein.
Norflox 400 mg Tablet is used in the treatment of bacterial infections. When this occurs, Tamm-Horsfall protein. Hydrated smooth by the painful ice ages, the highest mountain, stop taking Ciprofloxacin and pelvic your doctor immediately, Ciprofloxacin.
The current classification of ascites pathogens patients in three ones.