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ASCITES, (ἀσκίτης dropsical, from ἀσκός sc. νόσος disease), the term in medicine applied to an effusion of non-inflammatory fluid within the peritoneum. It is not a disease in itself, but is one of the manifestations of disease elsewhere—usually in the kidneys, heart, or in connexion with the liver (portal obstruction). Portal obstruction is the commonest cause of well-marked ascites. It is produced by (1) diseases within the liver, as cirrhosis (usually alcoholic) and cancer; (2) diseases outside the liver, as cancer of stomach, duodenum or pancreas, causing pressure on the portal vein, or enlarged glands in the fissure of the liver producing the same effect. Ascites is one of the late symptoms in the disease, and precedes dropsy of the leg, which may come on later, due to pressure on the large veins in the abdominal cavity by the ascitic fluid. In ascites due to heart disease, the dropsy of the feet and legs precedes the ascites, and there will be a history of palpitation, shortness of breath, and perhaps cough. In the ascites of kidney troubles there will be a history of general oedema—puffiness of face and eyes on rising in the morning probably having attracted the attention of the patient or his friends previously. Other less common causes of ascites are chronic peritonitis, either tuberculous in the young, or due to cancer in the aged, and more rarely still pernicious anaemia.
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