How do you manage symptomatic ascites in a patient with SBP?

In my personal practice, the management of symptomatic ascites in the setting of concurrent SBP is a complex situation and can lead to potential complications. As SBP is a common precipitant of HRS in a cirrhotic patient with ascites, especially if hemodynamically unstable, my answer is IT DEPENDS o...

I would be very cautious with your question to begin with.

For patients with an established diagnosis of ascites and SBP, I assume you already have a diagnostic paracentesis. In this case, if the patient still has "symptomatic ascites", the first question to ask is if the symptoms are truly from asc...

I would not use diuretics or perform an LVP when the patient is acutely infected, and the symptom is discomfort or dyspnea without significant hypoxemia. I would try to get them through 5 days of antibiotics, and then proceed with caution, using albumin infusion and limiting volume to 1-3 L - and th...