الفهرس 
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Abstract
The prevalence of HCV infection in Egypt increases steadily with age and high rates of infection are observed among persons in all age groups.
Ascites is the most common complication in patients with hepatic cirrhosis, the cumulative probability of developing ascites during the course of the disease was higher than the probability of presenting other complications such as gastrointestinal bleeding or hepatic encephalopathy.
In addition to the expected changes in cirrhotic patients, we can observe restrictive and obstructive changes in pulmonary function tests when there is ascites . The hypoxemia and decreased pulmonary volume seen in such cases improves after the ascites has been reduced.
Therefore , ascites , especially when sever and when combined with cirrhosis impairs pulmonary function in patients with portal hypertension The nature and degree of this impairment varies depending upon the aetiologiy of ascites.
In selected patients with ascites, large volume paracentesis (LVP) is considered an accepted therapeutic approach to tense ascites refractory to conventional medical therapy. The advantages of such approach are decreased hospital stay and a rapid improvement in symptoms. Recent studies consistently demonstrated an improvement in lung volumes following 5-L aspiration of ascetic fluid . No significant changes were documented in arterial oxygenation in eight cirrhotic patients studied by.