What are the dangers of the late stage symptoms of hepatic ascites

Ascites can be divided into early and late stages. If patients with liver disease want to prevent or detect ascites in time, they must start by understanding the symptoms of ascites. The symptoms of late-stage hepatic ascites are quite special and can be discovered with a little attention. At the same time, we should understand the dangers of late-stage hepatic ascites so that we can make psychological preparations and preventive measures early.

1. Late symptoms of hepatic ascites

1. Jaundice: It usually appears in the late stage and may be caused by liver cell damage, or by compression or invasion of the bile duct near the liver porta hepatis by cancerous masses, or by bile duct obstruction caused by the detachment of cancerous tissue and blood clots.

2. Pain in the liver area: More than 300 patients have pain in the liver area. The pain is equivalent to the location of the tumor, and it is mostly persistent distending pain or dull pain. Liver pain is caused by the rapid growth of the tumor, which causes the liver capsule to be stretched. If the lesion invades the diaphragm, the pain may involve the right shoulder. When a cancerous nodule ruptures, it may suddenly cause severe pain and symptoms and signs of peritonitis. If the amount of bleeding is large, it will cause syncope and shock.

3. Hepatomegaly: More than 90% of patients have enlarged livers, which are progressive, hard, uneven, with nodules or lumps of varying sizes, blunt and irregular edges, and often with varying degrees of tenderness. When liver cancer protrudes under the right costal arch or xiphoid process, the upper abdomen may appear locally bulging or full. If the tumor is located on the diaphragmatic surface, the main manifestation is the elevation of the diaphragm while the lower edge of the liver may not be enlarged. Because the arteries of liver cancer are rich and tortuous, or because the huge tumor compresses the hepatic artery or abdominal aorta, the inner diameter of the artery suddenly narrows, and sometimes a blowing-like vascular murmur can be heard on the abdominal wall close to the tumor.

2. The harm of late stage of hepatic ascites

1. In the late stage of hepatic ascites, due to the large amount of fluid accumulation in the abdominal cavity, the abdominal pressure increases, which compresses the abdominal blood vessels, especially the veins, causing venous collapse and blood reflux obstruction, causing venous congestion and congestive hypoxia, which reduces the intestinal peristalsis function, can cause severe abdominal distension, constipation, and reduced gastric acid secretion, and is conducive to bacterial reproduction, and the production and absorption of ammonia, aggravating ammonia poisoning. On the one hand, the diaphragm rises, the chest cavity shrinks, and the intrathoracic pressure increases, causing the lungs to expand and shrink, and the ventilation volume decreases, aggravating hypoxia. At the same time, the amount of blood returning to the heart decreases, and the cardiac output decreases, which can lower blood pressure. This is also a common hazard of late-stage ascites.

2. In the late stage of hepatic ascites, a large amount of plasma proteins, especially albumin and electrolytes, enter the abdominal cavity along with the ascites, which reduces the plasma protein and electrolyte levels, causing hypoproteinemia and hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia and other blood disorders, reducing the plasma colloid and crystal osmotic pressure, and promoting the formation of ascites, resulting in a vicious circle. It is an important cause of hepatic encephalopathy.

3. In the late stage of hepatic ascites, blood concentration, slow blood flow and increased blood coagulation may promote the formation of DIC.

4. After ascites is formed, a large amount of fluid infiltrates into the abdominal cavity, causing blood concentration, a decrease in effective circulating blood volume, increased blood viscosity, and slow blood flow, which can cause hypotension or shock. This reduces blood flow to the liver, aggravates liver ischemia and hypoxia, and aggravates liver cell necrosis. This is the most obvious harm of late-stage ascites.