SlideShare a Scribd company logo

Principles Of Management Of Ascites Combined

•Download as PPT, PDF•
•
S
sarafurness
Health & Medicine
1 of 41
PRINCIPLES OF MANAGEMENT OF ASCITES Richard Warner
[object Object],[object Object],[object Object]
Causes of Ascites- Normal Peritoneum SAAG >11g/l ,[object Object],[object Object],[object Object],[object Object]
Causes of Ascites- Normal Peritoneum SAAG >11g/l ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Ascites- Normal Peritoneum SAAG >11g/l ,[object Object],[object Object],[object Object],[object Object]
Causes of Ascites- Normal Peritoneum SAAG < 11g/l ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Ascites- Diseased Peritoneum SAAG < 11g/l ,[object Object]
Causes of Ascites- Diseased Peritoneum SAAG < 11g/l ,[object Object],[object Object]
 
 
Ascites is not just a Cosmetic Problem ! ,[object Object],[object Object],[object Object],[object Object]
Management of Ascites- Guidelines ,[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object]
Treatment Options ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ascites- Grading ,[object Object],[object Object],[object Object],[object Object]
Management of ascites- Bed Rest ,[object Object],[object Object]
Management of ascites- Sodium Restriction ,[object Object],[object Object],[object Object],[object Object],[object Object]
MANAGEMENT OF ASCITES- Salt restriction (cont) ,[object Object],[object Object]
MANAGEMENT OF ASCITES- WATER RESTRICTION ,[object Object],[object Object],[object Object],[object Object]
MANAGEMENT OF ASCITES- DIURETICS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ASCITES- Assess response to diuretics : ,[object Object],[object Object],[object Object]
Ascites- Paracentesis ,[object Object],[object Object]
Ascites- Paracentesis ,[object Object],[object Object],[object Object]
Paracentesis- Systemic Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Paracentesis ,[object Object],[object Object],[object Object]
Ascites- Refractory Ascites ,[object Object],[object Object],[object Object]
Refractory Ascites- Treatment Options ,[object Object],[object Object],[object Object],[object Object]
Refractory Ascites- Treatment Options ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Refractory Ascites- Treatment Options ,[object Object],[object Object],[object Object],[object Object]
 
 
Refractory Ascites- Treatment Options ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Refractory Ascites- Treatment Options ,[object Object]
TIPSS ,[object Object],[object Object],[object Object],[object Object]
 
TIPS vs. Paracentesis 58% vs.48 % 69% vs. 52% 61% vs.18% p=.006 60 Rossle et al NEJM, 2000 55% vs. 46% 71% vs. 35% 74% vs.35% p=.008 57 Salerno et al Hepatology 2002 38% vs. 12% 40% vs. 37% 58% vs. 16% p<.001 109 Sanyal et al Gastroenterology 2003 60% vs. 34% 41% vs. 35% 51% vs. 17% p=.003 70 Gines et al Gastroenterology, 2002 Encephalopathy Survival 1 Year Control of Ascites No. Patients Study
TIPS- Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ASCITES MX ,[object Object],[object Object],[object Object],[object Object],[object Object]
Any Questions?
TIPS VS PARACENTESIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TIPS VS PARACENTEISIS ,[object Object],[object Object],[object Object],[object Object],[object Object]

Recommended

Hypokalemia
Hypokalemia Hypokalemia
Hypokalemia Pasham sharath
 
Hyponatremia
HyponatremiaHyponatremia
HyponatremiaDoha Rasheedy
 
Upper Gastrointestinal Bleeding.pptx
Upper Gastrointestinal Bleeding.pptxUpper Gastrointestinal Bleeding.pptx
Upper Gastrointestinal Bleeding.pptxJwan AlSofi
 
hypokalemia, diagnosis and management
hypokalemia, diagnosis and managementhypokalemia, diagnosis and management
hypokalemia, diagnosis and managementSheila Ferrer
 
Hypokalemia
HypokalemiaHypokalemia
Hypokalemiasamirelansary
 
Ascites
AscitesAscites
AscitesZain Khan
 
CME - Hypokalemia
CME - HypokalemiaCME - Hypokalemia
CME - HypokalemiaStanley Medical College, Department of Medicine
 
hyponatremia
hyponatremiahyponatremia
hyponatremiaKaleem Chest Physician
 

Recommended

Hypokalemia
Hypokalemia Hypokalemia
Hypokalemia Pasham sharath
 
Hyponatremia
HyponatremiaHyponatremia
HyponatremiaDoha Rasheedy
 
Upper Gastrointestinal Bleeding.pptx
Upper Gastrointestinal Bleeding.pptxUpper Gastrointestinal Bleeding.pptx
Upper Gastrointestinal Bleeding.pptxJwan AlSofi
 
hypokalemia, diagnosis and management
hypokalemia, diagnosis and managementhypokalemia, diagnosis and management
hypokalemia, diagnosis and managementSheila Ferrer
 
Hypokalemia
HypokalemiaHypokalemia
Hypokalemiasamirelansary
 
Ascites
AscitesAscites
AscitesZain Khan
 
CME - Hypokalemia
CME - HypokalemiaCME - Hypokalemia
CME - HypokalemiaStanley Medical College, Department of Medicine
 
hyponatremia
hyponatremiahyponatremia
hyponatremiaKaleem Chest Physician
 
Hypercalcemia & Hypocalcemia -Dr. Nora Khreba
Hypercalcemia & Hypocalcemia -Dr. Nora KhrebaHypercalcemia & Hypocalcemia -Dr. Nora Khreba
Hypercalcemia & Hypocalcemia -Dr. Nora KhrebaMNDU net
 
Hypokalemia diagnosis, causes and treatment
Hypokalemia diagnosis, causes and treatmentHypokalemia diagnosis, causes and treatment
Hypokalemia diagnosis, causes and treatmentGarima Aggarwal
 
Chronic glomerulonephritis
Chronic glomerulonephritisChronic glomerulonephritis
Chronic glomerulonephritisArsenic Halcyon
 
Hyperkalemia 160108171542
Hyperkalemia 160108171542Hyperkalemia 160108171542
Hyperkalemia 160108171542Indhu Reddy
 
Approach to ascites
Approach to ascites Approach to ascites
Approach to ascites Dr Christian Nsanzabaganwa
 
Approach to hyponatremia
Approach to hyponatremiaApproach to hyponatremia
Approach to hyponatremiamanjil malla
 
hypernatremia
hypernatremiahypernatremia
hypernatremiaMehakinder Singh
 
Hypokalemia - Approach and Management
Hypokalemia - Approach and ManagementHypokalemia - Approach and Management
Hypokalemia - Approach and ManagementAdhiya Nss
 
Hypokalemia
HypokalemiaHypokalemia
HypokalemiaNisheeth Patel
 
Snake bite - ASV Protocols and Management - Antisnake Venom
Snake bite - ASV Protocols and Management - Antisnake VenomSnake bite - ASV Protocols and Management - Antisnake Venom
Snake bite - ASV Protocols and Management - Antisnake VenomChetan Ganteppanavar
 
CHRONIC GLOMERULONEPHRITIS
CHRONIC GLOMERULONEPHRITISCHRONIC GLOMERULONEPHRITIS
CHRONIC GLOMERULONEPHRITISMULLAPUDI RAMAKRISHNA
 
Approach to a patient with hyponatremia (2) (1)
Approach to a patient with hyponatremia (2) (1)Approach to a patient with hyponatremia (2) (1)
Approach to a patient with hyponatremia (2) (1)Mohit Aggarwal
 
Complications of cirrhosis review
Complications of cirrhosis reviewComplications of cirrhosis review
Complications of cirrhosis reviewkatejohnpunag
 
Hyponatremia
HyponatremiaHyponatremia
HyponatremiaSun Yai-Cheng
 
Ascites
AscitesAscites
AscitesAli Alwan
 
Management of chronic diarrhea
Management of chronic diarrheaManagement of chronic diarrhea
Management of chronic diarrheaANGAN KARMAKAR
 
Bartter’S And Gittleman’S Syndromes
Bartter’S And Gittleman’S SyndromesBartter’S And Gittleman’S Syndromes
Bartter’S And Gittleman’S Syndromesedwinchowyw
 
Liver cirrhosis
Liver cirrhosisLiver cirrhosis
Liver cirrhosisMustafa Zain
 
Lactic Acidosis
Lactic AcidosisLactic Acidosis
Lactic AcidosisWisit Cheungpasitporn
 
7. ACUTE LIVER FAILURE
7. ACUTE LIVER FAILURE7. ACUTE LIVER FAILURE
7. ACUTE LIVER FAILUREPratap Tiwari
 
Diagnosis and Treatment of Ascites
Diagnosis and Treatment of AscitesDiagnosis and Treatment of Ascites
Diagnosis and Treatment of AscitesWaleed El-Refaey
 
Approach to ascites
Approach to ascitesApproach to ascites
Approach to ascitesBikash Praharaj
 

More Related Content

What's hot

Hypercalcemia & Hypocalcemia -Dr. Nora Khreba
Hypercalcemia & Hypocalcemia -Dr. Nora KhrebaHypercalcemia & Hypocalcemia -Dr. Nora Khreba
Hypercalcemia & Hypocalcemia -Dr. Nora KhrebaMNDU net
 
Hypokalemia diagnosis, causes and treatment
Hypokalemia diagnosis, causes and treatmentHypokalemia diagnosis, causes and treatment
Hypokalemia diagnosis, causes and treatmentGarima Aggarwal
 
Chronic glomerulonephritis
Chronic glomerulonephritisChronic glomerulonephritis
Chronic glomerulonephritisArsenic Halcyon
 
Hyperkalemia 160108171542
Hyperkalemia 160108171542Hyperkalemia 160108171542
Hyperkalemia 160108171542Indhu Reddy
 
Approach to hyponatremia
Approach to hyponatremiaApproach to hyponatremia
Approach to hyponatremiamanjil malla
 
Hypokalemia - Approach and Management
Hypokalemia - Approach and ManagementHypokalemia - Approach and Management
Hypokalemia - Approach and ManagementAdhiya Nss
 
Snake bite - ASV Protocols and Management - Antisnake Venom
Snake bite - ASV Protocols and Management - Antisnake VenomSnake bite - ASV Protocols and Management - Antisnake Venom
Snake bite - ASV Protocols and Management - Antisnake VenomChetan Ganteppanavar
 
Approach to a patient with hyponatremia (2) (1)
Approach to a patient with hyponatremia (2) (1)Approach to a patient with hyponatremia (2) (1)
Approach to a patient with hyponatremia (2) (1)Mohit Aggarwal
 
Complications of cirrhosis review
Complications of cirrhosis reviewComplications of cirrhosis review
Complications of cirrhosis reviewkatejohnpunag
 
Management of chronic diarrhea
Management of chronic diarrheaManagement of chronic diarrhea
Management of chronic diarrheaANGAN KARMAKAR
 
Bartter’S And Gittleman’S Syndromes
Bartter’S And Gittleman’S SyndromesBartter’S And Gittleman’S Syndromes
Bartter’S And Gittleman’S Syndromesedwinchowyw
 
7. ACUTE LIVER FAILURE
7. ACUTE LIVER FAILURE7. ACUTE LIVER FAILURE
7. ACUTE LIVER FAILUREPratap Tiwari
 

What's hot (20)

Hypercalcemia & Hypocalcemia -Dr. Nora Khreba
Hypercalcemia & Hypocalcemia -Dr. Nora KhrebaHypercalcemia & Hypocalcemia -Dr. Nora Khreba
Hypercalcemia & Hypocalcemia -Dr. Nora Khreba
 
Hypokalemia diagnosis, causes and treatment
Hypokalemia diagnosis, causes and treatmentHypokalemia diagnosis, causes and treatment
Hypokalemia diagnosis, causes and treatment
 
Chronic glomerulonephritis
Chronic glomerulonephritisChronic glomerulonephritis
Chronic glomerulonephritis
 
Hyperkalemia 160108171542
Hyperkalemia 160108171542Hyperkalemia 160108171542
Hyperkalemia 160108171542
 
Approach to ascites
Approach to ascites Approach to ascites
Approach to ascites
 
Approach to hyponatremia
Approach to hyponatremiaApproach to hyponatremia
Approach to hyponatremia
 
hypernatremia
hypernatremiahypernatremia
hypernatremia
 
Hypokalemia - Approach and Management
Hypokalemia - Approach and ManagementHypokalemia - Approach and Management
Hypokalemia - Approach and Management
 
Hypokalemia
HypokalemiaHypokalemia
Hypokalemia
 
Snake bite - ASV Protocols and Management - Antisnake Venom
Snake bite - ASV Protocols and Management - Antisnake VenomSnake bite - ASV Protocols and Management - Antisnake Venom
Snake bite - ASV Protocols and Management - Antisnake Venom
 
CHRONIC GLOMERULONEPHRITIS
CHRONIC GLOMERULONEPHRITISCHRONIC GLOMERULONEPHRITIS
CHRONIC GLOMERULONEPHRITIS
 
Approach to a patient with hyponatremia (2) (1)
Approach to a patient with hyponatremia (2) (1)Approach to a patient with hyponatremia (2) (1)
Approach to a patient with hyponatremia (2) (1)
 
Complications of cirrhosis review
Complications of cirrhosis reviewComplications of cirrhosis review
Complications of cirrhosis review
 
Hyponatremia
HyponatremiaHyponatremia
Hyponatremia
 
Ascites
AscitesAscites
Ascites
 
Management of chronic diarrhea
Management of chronic diarrheaManagement of chronic diarrhea
Management of chronic diarrhea
 
Bartter’S And Gittleman’S Syndromes
Bartter’S And Gittleman’S SyndromesBartter’S And Gittleman’S Syndromes
Bartter’S And Gittleman’S Syndromes
 
Liver cirrhosis
Liver cirrhosisLiver cirrhosis
Liver cirrhosis
 
Lactic Acidosis
Lactic AcidosisLactic Acidosis
Lactic Acidosis
 
7. ACUTE LIVER FAILURE
7. ACUTE LIVER FAILURE7. ACUTE LIVER FAILURE
7. ACUTE LIVER FAILURE
 

Viewers also liked

Diagnosis and Treatment of Ascites
Diagnosis and Treatment of AscitesDiagnosis and Treatment of Ascites
Diagnosis and Treatment of AscitesWaleed El-Refaey
 
Cirrhotic Ascites Review
Cirrhotic Ascites Review Cirrhotic Ascites Review
Cirrhotic Ascites Review Brian Lee
 
Management of Cirrhotic Ascites and its Related Complications
Management of Cirrhotic Ascites and its Related ComplicationsManagement of Cirrhotic Ascites and its Related Complications
Management of Cirrhotic Ascites and its Related ComplicationsAhmed Adel
 
Anatomy of peritoneum
Anatomy of peritoneumAnatomy of peritoneum
Anatomy of peritoneumAhmed Salah
 
anatomy of Peritoneal spaces
anatomy of Peritoneal spaces anatomy of Peritoneal spaces
anatomy of Peritoneal spacesreddyvjm
 

Viewers also liked (12)

Diagnosis and Treatment of Ascites
Diagnosis and Treatment of AscitesDiagnosis and Treatment of Ascites
Diagnosis and Treatment of Ascites
 
Approach to ascites
Approach to ascitesApproach to ascites
Approach to ascites
 
Ascites
AscitesAscites
Ascites
 
Ascites mohamed sarhan
Ascites mohamed sarhanAscites mohamed sarhan
Ascites mohamed sarhan
 
ascites
ascites ascites
ascites
 
Ascites by_ Dr Mohammed Hussien
Ascites by_ Dr Mohammed HussienAscites by_ Dr Mohammed Hussien
Ascites by_ Dr Mohammed Hussien
 
Peritoneum
PeritoneumPeritoneum
Peritoneum
 
Cirrhotic Ascites Review
Cirrhotic Ascites Review Cirrhotic Ascites Review
Cirrhotic Ascites Review
 
Management of Cirrhotic Ascites and its Related Complications
Management of Cirrhotic Ascites and its Related ComplicationsManagement of Cirrhotic Ascites and its Related Complications
Management of Cirrhotic Ascites and its Related Complications
 
Ascites
AscitesAscites
Ascites
 
Anatomy of peritoneum
Anatomy of peritoneumAnatomy of peritoneum
Anatomy of peritoneum
 
anatomy of Peritoneal spaces
anatomy of Peritoneal spaces anatomy of Peritoneal spaces
anatomy of Peritoneal spaces
 

Similar to Principles Of Management Of Ascites Combined

Dr Damian Fogarty: Renal Failure-Detecting, Averting, Managing.
Dr Damian Fogarty: Renal Failure-Detecting, Averting, Managing.Dr Damian Fogarty: Renal Failure-Detecting, Averting, Managing.
Dr Damian Fogarty: Renal Failure-Detecting, Averting, Managing.Damian Fogarty
 
Gastrointestinalemergencies Richard
Gastrointestinalemergencies RichardGastrointestinalemergencies Richard
Gastrointestinalemergencies Richardsarafurness
 
How Best To Prevent & Manage Acute Renal failure
How Best To Prevent & Manage Acute Renal failureHow Best To Prevent & Manage Acute Renal failure
How Best To Prevent & Manage Acute Renal failurechandra talur
 
Ascites, SBP, HE medicine powerpoint.pptx
Ascites, SBP, HE medicine powerpoint.pptxAscites, SBP, HE medicine powerpoint.pptx
Ascites, SBP, HE medicine powerpoint.pptxsarathrajum17
 
Management of ascites
Management of ascitesManagement of ascites
Management of ascitesAhmed Owolabi
 
Ckd prevention
Ckd preventionCkd prevention
Ckd preventiondarsh 1980
 
34 chronic renal failure & dialysis
34 chronic renal failure & dialysis34 chronic renal failure & dialysis
34 chronic renal failure & dialysisDang Thanh Tuan
 
Hepatorenal syndrome
Hepatorenal syndromeHepatorenal syndrome
Hepatorenal syndromeAkshay Goel
 
Renal impairment and anaesthesia
Renal impairment and anaesthesiaRenal impairment and anaesthesia
Renal impairment and anaesthesiaErrol Williamson
 
Guidelines in ascites
Guidelines in ascitesGuidelines in ascites
Guidelines in ascitesMarlon Turaja
 
Hyponatremia 040113.ppt
Hyponatremia 040113.pptHyponatremia 040113.ppt
Hyponatremia 040113.pptRuban Raj
 
Hyponatremia 040113 (1)
Hyponatremia 040113 (1)Hyponatremia 040113 (1)
Hyponatremia 040113 (1)Saqib Iqbal
 
27 beans acute renal-failure
27 beans acute renal-failure27 beans acute renal-failure
27 beans acute renal-failureDang Thanh Tuan
 
Heart failure with CKD : How to Treat ?
Heart failure with CKD : How to Treat ?Heart failure with CKD : How to Treat ?
Heart failure with CKD : How to Treat ?drucsamal
 

Similar to Principles Of Management Of Ascites Combined (20)

Ascites.pptx
Ascites.pptxAscites.pptx
Ascites.pptx
 
Dr Damian Fogarty: Renal Failure-Detecting, Averting, Managing.
Dr Damian Fogarty: Renal Failure-Detecting, Averting, Managing.Dr Damian Fogarty: Renal Failure-Detecting, Averting, Managing.
Dr Damian Fogarty: Renal Failure-Detecting, Averting, Managing.
 
Gastrointestinalemergencies Richard
Gastrointestinalemergencies RichardGastrointestinalemergencies Richard
Gastrointestinalemergencies Richard
 
How Best To Prevent & Manage Acute Renal failure
How Best To Prevent & Manage Acute Renal failureHow Best To Prevent & Manage Acute Renal failure
How Best To Prevent & Manage Acute Renal failure
 
Ascites, SBP, HE medicine powerpoint.pptx
Ascites, SBP, HE medicine powerpoint.pptxAscites, SBP, HE medicine powerpoint.pptx
Ascites, SBP, HE medicine powerpoint.pptx
 
Management of ascites
Management of ascitesManagement of ascites
Management of ascites
 
Ckd prevention
Ckd preventionCkd prevention
Ckd prevention
 
26 acute renal failure
26 acute renal failure26 acute renal failure
26 acute renal failure
 
34 chronic renal failure & dialysis
34 chronic renal failure & dialysis34 chronic renal failure & dialysis
34 chronic renal failure & dialysis
 
Hepatorenal syndrome
Hepatorenal syndromeHepatorenal syndrome
Hepatorenal syndrome
 
Renal impairment and anaesthesia
Renal impairment and anaesthesiaRenal impairment and anaesthesia
Renal impairment and anaesthesia
 
Fibrosis[1]
Fibrosis[1]Fibrosis[1]
Fibrosis[1]
 
Guidelines in ascites
Guidelines in ascitesGuidelines in ascites
Guidelines in ascites
 
Prevention of AKI
Prevention of AKIPrevention of AKI
Prevention of AKI
 
Hyponatremia 040113.ppt
Hyponatremia 040113.pptHyponatremia 040113.ppt
Hyponatremia 040113.ppt
 
Hyponatremia 040113 (1)
Hyponatremia 040113 (1)Hyponatremia 040113 (1)
Hyponatremia 040113 (1)
 
Diabetic+Nephropathy
Diabetic+NephropathyDiabetic+Nephropathy
Diabetic+Nephropathy
 
Portal hypertension
Portal hypertensionPortal hypertension
Portal hypertension
 
27 beans acute renal-failure
27 beans acute renal-failure27 beans acute renal-failure
27 beans acute renal-failure
 
Heart failure with CKD : How to Treat ?
Heart failure with CKD : How to Treat ?Heart failure with CKD : How to Treat ?
Heart failure with CKD : How to Treat ?
 

More from sarafurness

Pre Emptive Transplantation
Pre Emptive TransplantationPre Emptive Transplantation
Pre Emptive Transplantationsarafurness
 
Keeping Healthy On Holiday
Keeping Healthy On HolidayKeeping Healthy On Holiday
Keeping Healthy On Holidaysarafurness
 
Reflux Nephropathy
Reflux NephropathyReflux Nephropathy
Reflux Nephropathysarafurness
 
An Unusual Cause Of Eosinophilia
An Unusual Cause Of EosinophiliaAn Unusual Cause Of Eosinophilia
An Unusual Cause Of Eosinophiliasarafurness
 
Sepsis & Medical Hdu
Sepsis & Medical HduSepsis & Medical Hdu
Sepsis & Medical Hdusarafurness
 
A Sore Arm & A Sore Head
A Sore Arm & A Sore HeadA Sore Arm & A Sore Head
A Sore Arm & A Sore Headsarafurness
 

More from sarafurness (7)

Alcoho1l Talk
Alcoho1l TalkAlcoho1l Talk
Alcoho1l Talk
 
Pre Emptive Transplantation
Pre Emptive TransplantationPre Emptive Transplantation
Pre Emptive Transplantation
 
Keeping Healthy On Holiday
Keeping Healthy On HolidayKeeping Healthy On Holiday
Keeping Healthy On Holiday
 
Reflux Nephropathy
Reflux NephropathyReflux Nephropathy
Reflux Nephropathy
 
An Unusual Cause Of Eosinophilia
An Unusual Cause Of EosinophiliaAn Unusual Cause Of Eosinophilia
An Unusual Cause Of Eosinophilia
 
Sepsis & Medical Hdu
Sepsis & Medical HduSepsis & Medical Hdu
Sepsis & Medical Hdu
 
A Sore Arm & A Sore Head
A Sore Arm & A Sore HeadA Sore Arm & A Sore Head
A Sore Arm & A Sore Head
 

Recently uploaded

VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...narwatsonia7
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...astropune
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsGfnyt
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...indiancallgirl4rent
 
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...narwatsonia7
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...chandars293
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Servicevidya singh
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipurparulsinha
 
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...Neha Kaur
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableDipal Arora
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...jageshsingh5554
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomdiscovermytutordmt
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...astropune
 
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableVip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableNehru place Escorts
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 

Recently uploaded (20)

VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
 
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
 
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...
VIP Russian Call Girls in Varanasi Samaira 8250192130 Independent Escort Serv...
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD available
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
 
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableVip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
 

Principles Of Management Of Ascites Combined

  • 1. PRINCIPLES OF MANAGEMENT OF ASCITES Richard Warner
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.  
  • 10.  
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.  
  • 31.  
  • 32.
  • 33.
  • 34.
  • 35.  
  • 36. TIPS vs. Paracentesis 58% vs.48 % 69% vs. 52% 61% vs.18% p=.006 60 Rossle et al NEJM, 2000 55% vs. 46% 71% vs. 35% 74% vs.35% p=.008 57 Salerno et al Hepatology 2002 38% vs. 12% 40% vs. 37% 58% vs. 16% p<.001 109 Sanyal et al Gastroenterology 2003 60% vs. 34% 41% vs. 35% 51% vs. 17% p=.003 70 Gines et al Gastroenterology, 2002 Encephalopathy Survival 1 Year Control of Ascites No. Patients Study
  • 37.
  • 38.
  • 40.
  • 41.