hepatic and biliary disorders
Ascites
Symptoms and Signs of Ascites
Small amounts of ascitic fluid cause no symptoms. Moderate amounts cause increased abdominal girth and weight gain. Massive amounts may cause nonspecific diffuse abdominal pressure, but actual pain is uncommon and suggests another cause of Acute Abdominal Pain . If ascites results in elevation of the diaphragm, dyspnea may occur. Symptoms of Signs include shifting dullness (detected by abdominal percussion) and a fluid wave. Volumes<1500 mL may not cause physical findings. Massive ascites causes tautness of the abdominal wall and flattening of the umbilicus. In liver diseases or peritoneal disorders, ascites is usually isolated or disproportionate to peripheral edema; in systemic diseases (eg, heart failure), the reverse is usually true. 