How is ascites formed in cancer

Ascites are the effusion of the liquid component of blood or lymph into the abdominal cavity. This process can occur with various diseases and pathologies, but it is most typical for liver diseases. In addition, ascites is quite common in cancer, and especially chylous ascites (formed by obstruction of the vessels of the lymphatic system).

In fifty percent of cases, ascites in cancer develops as a result of carcinomatosis of the parietal and visceral sheets of the peritoneum. This process ultimately leads to obstruction (obstruction) of the lymphatic vessels.

Frequency of occurrence of the latter among all malignant neoplasms ranges from fifteen to fifty-five percent. The most likely development of ascites in tumors of the ovaries, endometrium, stomach, mammary glands, bronchi and other organs and tissues.

About fifteen percent is formed with a tumor lesion of the liver parenchyma. The compression of the venous system of this organ leads to the rapid formation of effusion in the abdominal cavity, in addition, in these patients is formed not pronounced hepatomegaly.

Pathogenesis and symptoms of ascites in cancer

Ascites, the symptoms are characteristic for him - a sharp increase in the abdomen, as well as the overall weight of the patient. Increased pressure in the abdominal cavity leads to a high level of diaphragm standing, which, in turn, causes symptoms of gastroesophageal reflux (acid regurgitation and heartburn, nausea and vomiting), orthopnea and dyspnea, compressed stomach syndrome (rapid food satiety and nausea).

In physical examination, a small amount of ascitic fluid (up to 200 milliliters) is practically impossible to detect. The effusion volume from five hundred to a thousand milliliters is revealed visually as a result of protrusion of the region of the lateral flanks of the abdomen, the symptom of the fluctuation is positive. Observed characteristic of ascites "moving" dullness over the flanks when changing the position of the body during percussion.

Ascites in cancer, caused by a blockage of the venous system in the liver, is manifested by the expansion of the superficial veins of the abdominal wall. The late stages are characterized by the formation of the "jellyfish head" (protrusion of the anterior abdominal wall in ascites with enlarged and pronounced veins on it).

They also reveal an extraperitoneal complex of symptoms: fluid in the pleural cavity, displacement of the apical impulse of the heart, and edema of the lower parts of the thalax (predominantly the extremities and the lower abdomen).

In terminal stages of cancer, medium grade ascites does not worsen the patient's condition and does not pose a threat to life, therefore, only diuretic medicines are used, which increase the excretion of fluid from the body and thus reduce intra-abdominal effusion.

If ascites is diagnosed, treatment is carried out with veroshpiron (spironolactone) which is recognized as a "medical standard" in the treatment of such conditions. The purpose of this drug in combination with furosemide (loop diuretic), allows you to additionally remove from the body up to 1000 milliliters of fluid per day.

With pronounced ascites and the presence of pain and tachypnea, abdominal paracentesis is performed (puncture of the abdominal wall for the purpose of draining the cavity). Drainage is carried out for at least six hours and until the ascitic fluid ceases to flow into the vessel. The resulting liquid is sent for analysis, examining it for the total protein content, for the fractional composition of LDH and the quantitative content of leukocytes. In addition, the fluid is sown to the nutrient medium.

The pronounced positive effect gives an effect on the etiologic factor (directly on the tumor itself). Thus, the leading link in pathogenesis is eliminated and ascites in cancer retreats.