Ascites

Ascites is the accumulation of fluid within the peritoneal cavity. In children, ascites can occur from many different etiologies that vary by age. Various pathophysiologic mechanisms contribute to the formation of ascites, with peripheral arterial vasodilation playing a central role. Determining the etiology of ascites depends on a constellation of clinical and laboratory findings that can be confirmed by imaging and ascitic fluid analysis via diagnostic paracentesis. Management of ascites in children is directed at the underlying etiology. General management strategies include sodium and fluid restriction and diuresis. Complications of ascites can be life threatening and primarily include spontaneous bacterial peritonitis and refractory ascites.