Ascites in Children: a Single Center Experience of 27 years

OBJECTIVES:The aim of our study was to describe the changing prevalence, demographic features, etiologies, and treatment of ascites in children hospitalized over a 27 year period at the Johns Hopkins Hospital. METHODS:We retrospectively reviewed discharges from 1983–2010 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 grade 2&3 recognized by moderate and marked abdominal distension by physical examinations). RESULTS:We classified 518 children into 9 etiology groups105 had intrahepatic disease (IH), hepatic vein outflow obstruction (HVOO) (45), congestive heart disease (CH) (33), nephrotic syndrome (NS) (36), pancreatitis (26), inflammatory & infectious diseases (77), malignancy (49), idiopathic (71), and miscellaneous (76). IH and CH were predominant in younger age group (0–5 years) vs HVOO, pancreatitis and malignancy in the older age group (13–21 years) (p