Malignant Ascites: A Review of Pathogenesis and Management

Malignant ascites is defined as an accumulation of excess fluid in the peritoneal cavity secondary to a disseminated malignancy [1]. Apart from being a poor prognostic indicator it also adversely affects the patient’s quality of life [2]. According to an estimate, it affects around 3.6-6% of patients admitted in the palliative care unit [3]. Malignant ascites is an ominous sign with an average survival of around 20 weeks from its diagnosis [4]. Around 95% of patients have metastatic disease involving peritoneum, liver, bone and lungs [5]. Ovarian malignancy is the most common cause (37%) followed by pancreatobiliary (21%) and gastric malignancy (18%) [5]. Around 20% patients have unknown primary malignancy [6].