What causes refractory ascites?

What causes refractory ascites?

Refractory ascites is intractable and occurs in 5%–10% of all patients with ascites due to cirrhosis. Refractory ascites leads to a poor quality of life and high mortality rate. Ascites develops as a result of portal hypertension, which leads to water–sodium retention and renal failure.

When do you use SBP prophylaxis?

Prophylaxis should begin after the completion of antibiotic therapy for SBP (norfloxacin 400 mg daily) and should continue until resolution of ascites, liver transplantation, or death. Patients with cirrhosis who are admitted for upper GI hemorrhage should also receive antibiotic prophylaxis.

Why is spironolactone used for ascites?

1 Spironolactone. Spironolactone is an aldosterone antagonist, acting mainly on the distal tubules to increase natriuresis and conserve potassium. Spironolactone is the drug of choice in the initial treatment of ascites due to cirrhosis.

How is refractory ascites treated?

Therapy for refractory ascites is limited. The available therapies are repeated large volume paracentesis (LVP), transjugular intrahepatic portosystemic shunts, peritoneovenous shunts, investigational medical therapies, and liver transplantation. LVP with concomitant volume expanders is the initial treatment of choice.

Can you get SBP in malignant ascites?

Patients with malignant ascites may have elevated ascitic fluid white cell and PMN counts, but SBP in patients with malignant ascites is rare.

What is the best diuretic for ascites?

LJ Ascites is most commonly treated with a diuretic, which removes the fluid from the abdomen. The most common such agent is spironolactone (Aldactone, Pfizer), with furosemide (Lasix, Hoechst) frequently used as an adjuvant. These medications lead directly to decreased fluid in the abdomen.

What is refractory fluid?

Refractory edema is characterized by persistent swelling that does not respond to diuretic use and sodium restriction. Common causes include nonadherence to sodium or fluid restriction or the drug, reduced diuretic secretion, and deficiency of the kidney response to the drug.

What is the ICD 9 diagnosis code for other ascites?

Diagnosis Code 789.59. ICD-9: 789.59. Short Description: Ascites NEC. Long Description: Other ascites. This is the 2014 version of the ICD-9-CM diagnosis code 789.59. Code Classification. Symptoms, signs, and ill-defined conditions (780–799) Symptoms (780-789) 789 Other symptoms involving abdomen and pelvis.

What does it mean to have refractory ascites?

Refractory ascites is defined as ascites that does not recede or that recurs shortly after therapeutic paracentesis, despite sodium restriction and diuretic treatment.

When to use ICD-9 CM 571.5 cirrhosis of liver?

Short description: Cirrhosis of liver NOS. ICD-9-CM 571.5 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 571.5 should only be used for claims with a date of service on or before September 30, 2015.

When was the ICD-9 code 789.59 replaced?

789.59 is a legacy non-billable code used to specify a medical diagnosis of other ascites. This code was replaced on September 30, 2015 by its ICD-10 equivalent.