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Pathophysiology, Diagnosis, and Management of Pediatric Ascites

Giefer, Matthew J*; Murray, Karen F*; Colletti, Richard B

Journal of Pediatric Gastroenterology and Nutrition: May 2011 - Volume 52 - Issue 5 - p 503–513
doi: 10.1097/MPG.0b013e318213f9f6
Invited Review

The pediatric population has a number of unique considerations related to the diagnosis and treatment of ascites. This review summarizes the physiologic mechanisms for cirrhotic and noncirrhotic ascites and provides a comprehensive list of reported etiologies stratified by the patient's age. Characteristic findings on physical examination, diagnostic imaging, and abdominal paracentesis are also reviewed, with particular attention to those aspects that are unique to children. Medical and surgical treatments of ascites are discussed. Both prompt diagnosis and appropriate management of ascites are required to avoid associated morbidity and mortality.

*Division of Gastroenterology and Hepatology, Seattle Children's and University of Washington, Seattle, USA

University of Vermont College of Medicine, Burlington, USA.

Received 2 September, 2010

Accepted 14 January, 2011

Address correspondence and reprint requests to Karen F. Murray, MD, Seattle Children's Hospital, 4800 Sand Point Way NE, W-7830, Seattle, WA 98105 (e-mail:

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN