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Mild ascites is hard to notice, but severe ascites leads to swelling of the abdomen, the feeling of great weight and pressure in the belly as well as shortness of breath due to fluid buildup pushing on the diaphragm. Ascites is identified by visible bulging of the sides in the reclining patient ("flank bulging"), "shifting dullness" (difference in tapping noise made on the sides that moved when the patient is turned on their side) or in massive ascites with a "fluid thrill" or "fluid wave" (tapping or pushing on one side will generate a wave-like effect through the fluid that can be felt in the opposite side of the abdomen). Other signs of ascites may be present due to its underlying cause. For instance, in portal hypertension patients may also complain of leg swelling, bruising, gynecomastia, throwing up blood, or mental changes due to HE. |
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