Clinical Features

Progressive abdominal distention ; symptoms associated with increased abdominal distention include

• Early satiety

• Weight gain

• Dyspnea

• Diarrhea, which, if chronic, may be associated with features of malnutrition

Fluid wave test: wave produced by tapping one side of the abdomen in a patient in supine position; this wave will be transmitted to the other side via ascitic fluid.

Shifting dullness: change of resonance from dull to tympanic resonance when patient changes from supine to lateral decubitus position.

Flank dullness: typically elicited only if > 1.5 L of ascitic fluid is present [4]

Abdominal pain may be present

Abdominal wall hernias (e.g., umbilical, inguinal, or incisional hernias)

Peripheral or generalized edema

Enlarged liver, jaundice, spider angioma, palmar erythema: signs of chronic liver disease

Elevated jugular venous pressure: heart failure

Virchow node and weight loss: abdominal or pelvic malignancy