Ascites in children: A single-center experience of 27 years

Wikrom Karnsakul, Thammasin Ingviya, Eric Seaberg, Pavis Laengvejkal, Hejab Imteyaz, Alexandra Vasilescu, Kathleen B. Schwarz, Ann O. Scheimann

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objectives: The aim of our study was to describe the changing prevalence, demographic features, etiologies, and treatment of ascites in children hospitalized during a 27-year period at the Johns Hopkins Hospital (Baltimore, MD). Methods: We retrospectively reviewed discharges from 1983 to 2010 to select patients whose records included a diagnosis of ascites. We assessed the etiologies and degrees of ascites (ascites grade 1 detectable only by radiologic tests; ascites grades 2 and 3 recognized by moderate and marked abdominal distension by physical examinations). Results: We classified 518 children into 9 etiology groups: intrahepatic disease (IH) (105), hepatic vein outflow obstruction (HVOO) (45), congestive heart disease (CH) (33), nephrotic syndrome (NS) (36), pancreatitis (26), inflammatory and infectious diseases (77), malignancy (49), idiopathic (71), and miscellaneous (76). IH and CH were predominant in the younger age group (0-5 years) versus HVOO, pancreatitis, and malignancy in the older age group (13-21 years) (P<0.001). The prevalence of ascites increased over time from 1983 to 2006 and declined thereafter. Ascites grade 1 was more common than ascites grades 2 and 3 in all the groups (P=0.048). IH and NS were more likely to have ascites grade 2 and 3 (P=0.02). Although spironolactone was more frequently used in the IH group versus other etiologies, furosemide was used more frequently in NS and CH versus other etiologies (P<0.001). Conclusions: The increased prevalence of ascites during the initial study period could reflect improved detection radiologic detection. The proportion of severe ascites and the various medical treatments differed among the etiologic groups.

Original languageEnglish (US)
Pages (from-to)83-88
Number of pages6
JournalJournal of pediatric gastroenterology and nutrition
Issue number1
StatePublished - 2017


  • Ascites cause
  • Ascitic grades
  • Degrees of ascites
  • Etiology
  • Pediatric ascites

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health


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