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Drainage of Fluid Collections

Ascites Treatments

Ascites is the term given to the accumulation of fluid in the peritoneal cavity which contains the bowels and major organs like the liver, spleen, gall bladder, pancreas and kidneys. This fluid would normally be removed naturally before an excess builds up. There are many causes for ascites, including liver failure, inflammatory and infective processes but one of the commonest causes is cancer. The commonest tumours associated with ascites typically arise from the bowel, pancreas, liver, ovaries and breast. Many litres of fluid can accumulate and this causes abdominal distension, bowel habit disturbance, appetite loss and general nausea and malaise. The commonest treatments include the use of diuretics such as Spironolactone and drainage of the fluid called Paracentesis. The latter although reasonably effective has the disadvantage that it may need to be repeated (sometimes weekly) and each time fluid is removed, it is simply discarded with loss of valuable nutrients such as protein which are essential to maintain body muscle and provide defence against disease, especially infection. Although, protein can be given intravenously, this is usually inadequate and expensive. A minimally invasive technique offered by The Imaging Clinic in Guildford is to ‘shunt’ this valuable fluid from the peritoneal cavity back into the body’s blood circulation allowing excess fluid to be removed conventionally by the kidneys leaving the valuable proteins in the body. The procedure usually only needs to be performed once and the Denver Peritoneovenous shunt contains a filter to allow fluid and essential macromolecules like protein to recirculate whilst preventing the passage of cancer cells. The procedure is performed under local anaesthesia and mild sedation and usually takes 40 – 50 minutes. Recovery is rapid and patients are encouraged to return home in 24 – 48 hours. It must however be remembered that the procedure is not a cure for cancer but may be useful in managing the distressing side effects of ascites. The Imaging Clinic is also happy to drain the ascites fluid with ultrasound guided placement of the drain. This is usually performed initially until it is established how quickly the ascites is accumulating.