Cases reported "Ascites"

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121/1044. Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: a series of 10 cases.

    Ten patients with peritoneal tuberculosis who were operated on for suspected advanced ovarian cancer during a 5-year period were analyzed. These 10 cases constituted 1.4% of the 728 new gynecologic cancer cases diagnosed and treated at our department during the same time period. Data were obtained from patients' files and pathology reports. The mean age of cases was 40.6 /- 6.1 (median 37; range 18-72). ascites was present together with ill-defined nodularities or thickening in the Douglas pouch and/or in the adnexal areas on pelvic examination in all patients but three, who presented with well-demarcated adnexal masses of about 5 cm in diameter. All patients had elevated serum CA 125 levels with a median of 331 U/ml, (40-560 U/ml). Ultrasound and abdominopelvic CT examinations revealed omental and mesenteric thickening in addition to ascites in all patients, cystic ovarian masses or ovarian enlargement in five, and peritoneal implants in two. Abdominal paracentesis performed in the six cases in whom the findings were felt to be most inconclusive for the diagnosis of ovarian cancer revealed clear exudative fluid with benign cells. Mycobacteria could not be demonstrated on direct preparations. tuberculosis was diagnosed at laparotomy in all. patients received antituberculous therapy and serum CA 125 levels returned to normal within 2 months after the beginning of treatment. This case series demonstrates a high rate of misdiagnosis between advanced ovarian cancer and peritoneal tuberculosis. Whereas abdominal paracentesis is useless in ruling out peritoneal tuberculosis, and serum CA 125 levels are not helpful in the differential diagnosis, the latter marker may be useful in the follow-up of patients.
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122/1044. Spontaneous perforation of the extrahepatic bile duct in an infant.

    A 1.2-year-old male presented with gradual-onset biliary ascites, mild icterus, and failure to thrive due to spontaneous bile-duct perforation (SPBD) confirmed by technetium 99Tc HIDA scan and abdominal paracentesis. Peritoneal tube drainage for 2 weeks helped the perforation to seal spontaneously, as there was no distal obstruction. No surgery was needed. Only less than 100 cases of SPBD have been reported in the English literature. The pathogenesis and treatment options are reviewed and discussed.
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123/1044. Recurrent ascites and pleural effusions after surgery for early-stage endometrial adenocarcinoma.

    A case of massive postoperative ascites in a woman treated for endometrial cancer is reported. A workup for typical causes of ascites yielded negative results, prompting a more detailed analysis of the patient's condition. hypothyroidism was discovered. After correction of the hypothyroidism, the ascites slowly resolved. Since myxedema is an uncommon cause of ascites, this is usually a diagnosis of exclusion. However, hypothyroidism must be ruled out to prevent unnecessary and possibly inappropriate treatments for ascites.
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124/1044. Malignant peritoneal mesothelioma.

    Malignant peritoneal mesotheliomas are rare tumors arising from the peritoneal surface. We report a 53 year old, non-asbestos exposed Saudi male who presented with exudative ascites. The diagnosis was obtained from laparoscopic biopsy. To the best of our knowledge this entity has not been described in the Saudi community. The aim is to increase the awareness among the medical community about this rare entity.
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125/1044. Transjugular intrahepatic portosystemic shunt placement in the setting of polycystic liver disease: questioning the contraindication.

    Although polycystic liver disease has long been listed as a contraindication to transjugular intrahepatic portosystemic shunt (TIPS) creation, two cases of TIPS placement in that particular clinical setting have been reported. Another case is reported in this article and the clinical course over 21 months of follow-up is examined. The discussion reviews the mechanics of TIPS creation in a polycystic liver and the vague premise of the polycystic liver as a contraindication to TIPS.
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126/1044. Pelvic tuberculosis mimicking signs of abdominopelvic malignancy.

    We discuss the clinical presentation and consequences of pelvic tuberculosis in the context of 3 cases having developed typical signs and symptoms of ascites and abdominal mass. These cases are reported to emphasize the difficulty of early diagnosis and treatment of the disease.
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127/1044. Ultrasound assessment in a case of sialic acid storage disease.

    A woman was referred to our unit at 25 weeks' gestation because of fetal ascites. Conventional and three-dimensional ultrasound examinations revealed coarse facies and micromelia which strongly suggested storage disease, despite the absence of an index familial case. amniocentesis was performed and, in view of the poor prognosis, the pregnancy was terminated. autopsy confirmed all the sonographic features and the cultured amniocytes confirmed the diagnosis of infantile sialic acid storage disease.
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128/1044. Lichen myxedematosus with systemic involvement: clinical and autopsy findings.

    Lichen myxedematosus is a rare disease that is characterized by the formation of lichenoid papules and plaques. Histologic examination shows deposition of mucinous material in the dermis. We report the case of a patient with cutaneous and systemic involvement and examine the clinical and postmortem data.
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129/1044. Abdominal ultrasonography in a mesenteric cyst presenting as ascites.

    A case of a mesenteric cyst presenting as the sudden onset of bloody ascites is reported. The diagnosis was suggested by abdominal ultrasonography.
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130/1044. Abdominal pseudocysts and ascites formation after ventriculoperitoneal shunt procedures. Report of four cases.

    The authors report three patients with abdominal pseudocysts and one with cerebrospinal fluid ascites as late complications of ventriculoperitoneal shunts. The presenting signs and symptoms were those of intraabdominal abnormality, with no neurological symptoms suggestive of shunt malfunction.
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Last update: September 2014