What are the symptoms of late-stage hepatic ascites

Ascites is an inflammation of the liver, which is mainly caused by problems with the liver. Hepatic ascites can develop from early stage to late stage. Many people don’t know what the symptoms of late-stage ascites are. In this case, the patient may experience multiple symptoms such as jaundice.

1. Jaundice: It usually appears in the late stage and may be caused by liver cell damage, or by compression or invasion of the bile duct near the liver porta hepatis by cancerous masses, or by bile duct obstruction caused by the detachment of cancerous tissue and blood clots. This is one of the late features of hepatic ascites.

2. Pain in the liver area: More than 300 patients have pain in the liver area. The pain is equivalent to the location of the tumor, and it is mostly persistent distending pain or dull pain. Liver pain is caused by the rapid growth of the tumor, which causes the liver capsule to be stretched. If the lesion invades the diaphragm, the pain may involve the right shoulder. When a cancerous nodule ruptures, it may suddenly cause severe pain and symptoms and signs of peritonitis. If the amount of bleeding is large, it will cause syncope and shock.

3. Hepatomegaly: More than 90% of patients have enlarged livers, which are progressive, hard, uneven, with nodules or lumps of varying sizes, blunt and irregular edges, and often with varying degrees of tenderness. When liver cancer protrudes under the right costal arch or xiphoid process, the upper abdomen may appear locally bulging or full. If the tumor is located on the diaphragmatic surface, the main manifestation is the elevation of the diaphragm while the lower edge of the liver may not be enlarged. Because the arteries of liver cancer are rich and tortuous, or because the huge tumor compresses the hepatic artery or abdominal aorta, the inner diameter of the artery suddenly narrows, and sometimes a blowing-like vascular murmur can be heard on the abdominal wall close to the tumor. This is also a late feature of hepatic ascites.

4. Signs of cirrhosis: Patients with liver cancer and portal hypertension accompanied by cirrhosis may have symptoms such as splenomegaly, ascites, and formation of venous collateral circulation. The ascites increases rapidly, usually as transudate. Bloody ascites is mostly caused by cancer invading the liver capsule or rupturing into the abdominal cavity, and occasionally by peritoneal metastasis.

5. Symptoms of metastasis: If metastasis occurs to the lungs, bones, chest cavity, etc., corresponding symptoms may occur. Pleural metastasis is more common on the right side and may be accompanied by signs of pleural effusion. Bone or spinal metastasis may cause local tenderness or nerve compression symptoms, and intracranial metastasis may cause neurological localization signs. This is also a late feature of hepatic ascites.