Nonhepatic causes include the following: Generalized fluid retention associated with systemic diseases (eg, heart failure, nephrotic syndrome, severe hypoalbuminemia, constrictive pericarditis) Peritoneal disorders (eg, carcinomatous or infectious peritonitis, biliary leak due to surgery or another medical procedure) Less common causes, such as renal dialysis, pancreatitis, systemic lupus erythematosus, and endocrine disorders (eg, myxedema) Pathophysiology of Ascites Mechanisms are complex and incompletely understood.