Liquido nella pancia (ascite), tumore e altre cause

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Con il termine medico ascite si indica un accumulo di liquido nella pancia, ovvero in quella che viene definita cavità peritoneale. Quando la quantità di fluido è minima difficilmente si può vedere ad occhio nudo, ma sue grandi quantità rendono l’addome particolarmente sporgente. Quali sono le cause di tale condizione oltre al tanto temuto tumore? E cosa fare?

liquido pancia ascite cause


Cause

L’ascite addominale è spesso causata da cirrosi epatica dovuta ad alcolismo, non a caso molti dei casi definiti come “pancia da birra” si rivelano come ascite. Da non sottovalutare anche l’insufficienza cardiaca che può portare ad un accumulo di liquidi nell’addome e nelle caviglie, polsi, piedi e mani. Liquido nella pancia si forma anche in seguito a tubercolosi, pancreatite e cancro dell’addome. Spesso l’ascite rappresenta anche uno dei sintomi di queste condizioni di salute, tutte serie.

Sintomi di ascite

La pancia che si gonfia non è l’unico sintomo. Maggiore è l’accumulo di liquido, e maggiore è la pressione sul diaframma, che può causare respiro corto. La maggior parte degli altri sintomi associati con ascite si riferiscono direttamente alle sue cause sottostanti. Ad esempio, una persona con questo accumulo e che ha anche tosse persistente e la febbre può essere valutata per la tubercolosi. Chi invece vi abbina una colorazione gialla della pelle e ittero può soffrire di una disfunzione epatica.

Diagnosi

La diagnosi mira ad individuare in primis la presenza di liquido nella pancia e poi ad identificarne la causa. Questo si fa con una visita clinica che prevede anche la palpazione eventuale dell’addome, esami del sangue (con emocromo completo, test per la funzionalità epatica, renale e di coagulazione del sangue oltre che la ricerca di virus come quello dell’epatite) Utile l’ecografia all’addome (con doppler) anche per stabilire l’effettiva quantità di liquido accumulato nella pancia. A tutto ciò si abbina una paracentesi, ovvero il prelievo attraverso un ago di una parte del fluido ascitico da analizzare al dettaglio in laboratorio.

Terapia per eliminare il liquido nella pancia

Quando i pazienti presentano un’ascite grave, la paracentesi serve anche per estrarre i liquidi in eccesso dalla cavità peritoneale. Nei casi più lievi si può procedere con farmaci diuretici ed una dieta a basso contenuto di sodio oltre che alla cura della patologia scatenante: ad esempio con antibiotici in caso di tubercolosi o antivirali se si è in presenza di epatite. Per problemi cardiaci può essere necessaria la chirurgia. Per l’ascite grave da cirrosi epatica la cura ideale è il trapianto di fegato, purtroppo non sempre possibile.

Prognosi

In generale, quando la causa sottostante di ascite può essere determinata e trattata, le prospettive di vita e di guarigione sono buone, anche grazie ad un attento e successivo monitoraggio in grado di prevenire le recidive. Per chi non può essere curato in tal senso, il trattamento dell’ascite addominale si concentrerà sulla riduzione di tutto il disagio che provoca. Purtroppo, questa condizione significa spesso gravi condizioni sottostanti che accorciano l’aspettativa di vita.

 

 

 

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Ecografia all’addome, a cosa serve e come si fa

 

Foto: Thinkstock

Fonte: Wisegeek.org

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