2017 Korean Association for the Study of the Liver (KASL) Clinical Practice Guidelines for Ascites and Related Complications: What Has Been Changed from the 2011 KASL Clinical Practice Guidelines?

Yeon Seok Seo

doi:10.4166/kjg.2018.72.4.179

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Seo: 2017 Korean Association for the Study of the Liver (KASL) Clinical Practice Guidelines for Ascites and Related Complications: What Has Been Changed from the 2011 KASL Clinical Practice Guidelines?

Brief Summary of Practice Guideline

The Korean Journal of Gastroenterology 2018; 72(4): 179-187.

Published online: 30 October 2018

DOI: https://doi.org/10.4166/kjg.2018.72.4.179

2017 Korean Association for the Study of the Liver (KASL) Clinical Practice Guidelines for Ascites and Related Complications: What Has Been Changed from the 2011 KASL Clinical Practice Guidelines?

Yeon Seok Seo

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Correspondence to: Yeon Seok Seo, Department of Internal Medicine, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea. Tel: +82-2-920-6608, Fax: +82-2-953-1943, drseo@korea.ac.kr

Received 19 September 2018 Revised 28 September 2018 Accepted 28 September 2018

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ascites is a common complication in patients with liver cirrhosis and is the most common cause of hospitalization in these patients. The development of ascites is associated with a poor prognosis in patients with liver cirrhosis with a higher mortality rate than in those without ascites. Furthermore, the presence of cirrhotic ascites is related to the development of various serious complications, such as refractory ascites, spontaneous bacterial peritonitis, acute kidney injury, and hepatorenal syndrome. Therefore, early detection and appropriate management for the development of ascites and their complications is very important in these patients. Recently, there have been significant revisions in the diagnostic criteria and treatment of cirrhotic ascites and their complications. This manuscript reviews these revisions.

Keywords: Liver cirrhosis, Ascites, Hypertension, portal, Acute kidney injury, Guideline

Figures and Tables

Fig. 1

Algorithm for the differential diagnosis of ascites. SAAG, serum-ascites albumin gradient; CHF, congestive heart failure; IVC, inferior vena cava; PMN, polymorphonuclear leukocyte.

Fig. 2

Treatment of cirrhotic ascites according to the grades of ascites. Grade 1, minimal ascites, which can be detected only by an imaging study, such as abdominal ultrasound; grade 2, moderate ascites which can be identified easily by a visual inspection and palpation; and grade 3, massive or tense ascites with profound distension of the abdomen.

Notes

^{Financial support} None.

^{Conflict of interest} None.

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ORCID iDs: Yeon Seok Seo
https://orcid.org/0000-0003-4171-6331
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