A patient with malignant ascites has intra-abdominal pressure above 20 mmHg, oliguria, rising airway pressures and no immediately operable cause.

Question

A patient with malignant ascites has intra-abdominal pressure above 20 mmHg, oliguria, rising airway pressures and no immediately operable cause. Which urgent palliative intervention most directly reverses the physiology?

Accepted Answer

Urgent image-guided large-volume paracentesis with haemodynamic and renal monitoring

Answer

Commence spironolactone alone and review abdominal pressure after five days

Answer

Insert a peritoneovenous shunt before undertaking any pressure-relieving drainage

Answer

Apply a firm abdominal binder and increase positive end-expiratory pressure

Answer

Observe for 48 hours because malignant ascites rarely compromises organ perfusion

Abdominal Compartment Syndrome from Ascites — SCE Palliative Medicine MCQ

A patient with malignant ascites has intra-abdominal pressure above 20 mmHg, oliguria, rising airway pressures and no immediately operable cause. Which urgent palliative intervention most directly reverses the physiology?