Re: Happy New Year and Question about Ascites

[Guest guest]

Dear Tina;

I am very sorry to hear about Bill's ascites and elevated creatinine.

The following page describes liver biopsy procedures:

http://www.healthscout.com/ency/article/003895.htm

One option seems to be .....

" The procedure can also be performed by inserting a needle into the

jugular vein in the neck and passing a catheter through the veins

down to the liver to obtain the sample. "

Perhaps this is what they meant by a " juggular biopsy " ?

However, as Stefan mentioned it is possible that they were referring

to a procedure called " Transjugular intrahepatic portacaval shunt

(TIPS) " :

http://www.emedicine.com/med/topic173.htm

" TIPS is an interventional radiologic technique that reduces portal

pressure and may be the most efficacious for treatment of patients

with diuretic-resistant ascites. This procedure consists of inserting

a long metal needle from the right jugular vein into the hepatic

vein. This is slowly becoming the standard of care in patients with

diuretic-refractory ascites. "

The main treatment for ascites seems to be use of diuretics with a

sodium-restricted diet.

High serum creatinine is usually a sign of impaired kidney function

which can often accompany ascites:

http://www.nlm.nih.gov/medlineplus/ency/article/003475.htm

Has Bill had a MELD score calculated? One of the numbers used to

calculate MELD is serum creatinine level:

http://www.thedrugmonitor.com/meld.html

" MELD score is calculated using a relatively simple formula that

relies on three readily available objective variables:

Serum creatinine (Scr; mg/dL)

Total bilirubin (Tbil; mg/dL)

INR (international normalized ratio) "

I hope this answers your questions. Let us know if you have any

others.

Best regards,

Dave

(father of (19); PSC 07/03; UC 08/03)