What is ascites?

• A. Abdominal swelling caused by the buildup of fluid
• B. Abdominal swelling due to gas
• C. Abdominal swelling due to fatty infiltration
• D. Abdominal swelling due to tumor growth

Answer: (A)

Ascites is the abnormal accumulation of fluid in the peritoneal cavity, causing abdominal swelling. This fluid buildup isn’t from gas, fat, or a solid tumor; it’s fluid that collects in the space between abdominal organs and the abdominal wall. The most common scenario is liver disease, such as cirrhosis, which raises pressure in the portal circulation and lowers blood albumin levels. The combination of higher hydrostatic pressure and lower oncotic pressure pushes fluid out of vessels into the peritoneal cavity, creating a transudative fluid buildup that enlarges the abdomen. Clinically, this can present as a distended, taut belly and may show shifting dullness or a fluid wave. Diagnosis often involves paracentesis and measuring the serum-ascites albumin gradient. Gas-related swelling is from air, fatty infiltration is fat deposition, and tumor growth refers to a solid mass—none of which define ascites.