Aszitesbildung

Aszitesbildung, also known as ascites formation, refers to the accumulation of fluid within the peritoneal cavity, the space surrounding the abdominal organs. This condition is a common manifestation of various underlying diseases, particularly liver cirrhosis, but can also result from cancer, heart failure, infections, and other systemic illnesses.

The pathophysiology of aszitesbildung primarily involves an imbalance in fluid regulation. In liver cirrhosis, portal hypertension increases hydrostatic pressure in the portal venous system, promoting fluid leakage from blood vessels into the peritoneal cavity. Additionally, decreased synthesis of albumin by the damaged liver reduces plasma oncotic pressure, further facilitating fluid accumulation. Activation of the renin-angiotensin-aldosterone system leads to sodium and water retention, exacerbating the fluid buildup.

Clinically, aszites may present with abdominal distension, discomfort, and weight gain. In some cases, it remains asymptomatic and is discovered incidentally during examinations or imaging studies. Large accumulations can impair diaphragm movement and compromise respiratory function.

Diagnosis involves a combination of physical examination, imaging techniques such as ultrasound, and analysis of the ascitic fluid obtained via paracentesis. Laboratory tests assess cell counts, albumin levels, and for signs of infection or malignancy.

Treatment aims to address the underlying cause and manage symptoms. Therapeutic paracentesis can relieve discomfort, while medications like diuretics help reduce fluid volume. In cases of liver cirrhosis, additional interventions such as transjugular intrahepatic portosystemic shunt (TIPS) or liver transplantation may be considered. Managing aszites requires careful monitoring to prevent complications such as infections or renal impairment.