131/1044. Management of pancreatic ascites.Two patients with persistent pancreatic ascites are presented. Both were managed successfully by internal drainage. A trial of nonoperative treatment with nasogastric intubation and intravenous hyperalimentation is advocated for patients with pancreatic ascites. patients who fail to improve usually have a pancreatic duct disruption and should have internal drainage operation and/or distal pancreatic resection.- - - - - - - - - - ranking = 1keywords = e (Clic here for more details about this article) |
132/1044. Spontaneous bladder rupture secondary to posterior urethral valves in a neonate.Bladder rupture is a rare cause of ascites in neonates. A review of literature revealed about 32 cases including both iatrogenic and spontaneous rupture. This case report describes a successfully treated case of spontaneous rupture of bladder with ascites in a neonate with posterior urethral valves.- - - - - - - - - - ranking = 1.3396226415094keywords = e (Clic here for more details about this article) |
133/1044. Postoperative ascites developing after laparoscopic surgery can become a difficult diagnostic dilemma.Postoperative ascites is a rare complication of laparoscopic surgery. life-threatening and serious etiologies such as unrecognized bowel or urinary tract injury should be excluded promptly to avoid prolonged morbidity and even mortality. Occasionally, no definitive cause can be identified after an extensive diagnostic work-up. In such cases, idiopathic allergic or inflammatory peritoneal reaction may be the final diagnosis.- - - - - - - - - - ranking = 1.4528301886792keywords = e (Clic here for more details about this article) |
134/1044. Meigs' syndrome with an elevated CA 125 from benign Brenner tumors.BACKGROUND: Meigs' syndrome refers to solid, benign ovarian tumors, ascites, hydrothorax, and resolution of these signs after surgery. Meigs' syndrome with an elevated CA 125 secondary to benign Brenner tumors is exceedingly rare. CASE: A postmenopausal woman presented with a large pelvic mass, ascites, and a right pleural effusion. serum CA 125 was 759 IU/mL. ascitic fluid, pleural fluid, and fine needle aspiration of the mass were without evidence of malignancy. Exploratory laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy revealed benign Brenner tumors. Immunohistochemical staining for CA 125 showed immunoreactivity in the omentum only. Postoperatively, her signs and symptoms resolved completely and did not recur. CONCLUSION: Cytologic or histologic confirmation of malignancy is imperative in patients with a pelvic mass, ascites, hydrothorax, and elevated CA 125 before initiating chemotherapy.- - - - - - - - - - ranking = 2.1132075471698keywords = e (Clic here for more details about this article) |
135/1044. Malignant ascites: new concepts in pathophysiology, diagnosis, and management.Malignant ascites is a manifestation of advanced malignant disease that is associated with significant morbidity. Mainstays of treatment include diuretics and recurrent large volume paracentesis. Although lymphatic obstruction has been considered the major pathophysiologic mechanism behind its formation, recent evidence suggests that immune modulators, vascular permeability factors, and metalloproteinases are contributing significantly to the process. These new observations offer the opportunity for development of new, more targeted therapies for the treatment of malignant ascites. This article uses a clinical case to highlight the problem, then reviews these new concepts in the pathophysiology of malignant ascites formation. The diagnosis and management of this challenging medical problem are subsequently discussed, with emphasis on how these new pathophysiologic insights are being applied to the development of novel therapies that may soon change how we manage this troubling clinical condition.- - - - - - - - - - ranking = 2.2264150943396keywords = e (Clic here for more details about this article) |
136/1044. Isolated foetal ascites.The prenatal diagnosis and perinatal outcome of two patients with isolated foetal ascites compatible with chyloperitoneum is described. The foetal ascites resolved spontaneously after delivery with good perinatal outcome in both cases. A good prognosis can be anticipated in such cases. Antepartum and intrapartum interventions are seldom necessary.- - - - - - - - - - ranking = 0.88679245283019keywords = e (Clic here for more details about this article) |
137/1044. Dehydrated hereditary stomatocytosis: a cause of prenatal ascites.Dehydrated hereditary stomatocytosis (DHS) is a rare congenital hemolytic anemia. We observed that some patients had presented with different prenatal or perinatal forms of edema in some kindreds. Within weeks or months after birth, these exhibited a spontaneous, complete and definitive resorption. We assumed that some DHS patients, who were born without edema before ultrasound was available, might nonetheless have exhibited this during the prenatal period. The present report follows up the first pregnancy in a woman with overt DHS, but not herself having a known history of perinatal effusions. Ultrasound revealed that the fetus displayed ascites that disappeared prior to birth. The neonate had DHS. Prenatal edema must therefore be more frequent in DHS than known until now. DHS is another cause of prenatal edema to be considered in the differential diagnosis.- - - - - - - - - - ranking = 2.4339622641509keywords = e (Clic here for more details about this article) |
138/1044. carcinoid heart disease: successful tricuspid valve replacement.A woman aged 46 was found to have severe tricuspid valve disease 14 years after the diagnosis of a malignant carcinoid tumour of the ileum and 33 years after the onset of symptoms attributable to the disease. Increasing ascites requiring repeated paracentesis had not responded to chemotherapy including infusion of 5-fluorouracil and vincristine into the coeliac artery. The tricuspid valve was replaced by a Bjork-Shiley prosthesis. After operation there was no recurrence of ascites or oedema. She remains well one year and 11 months later. It is suggested that valve replacement surgery should be considered more often in patients with carcinoid heart disease. hepatomegaly and ascites sould not be attributed too readily to advancing malignant disease without careful consideration of the role of right-sided valvar lesions in the production of these signs.- - - - - - - - - - ranking = 2.3396226415094keywords = e (Clic here for more details about this article) |
139/1044. CD3 CD4-CD8-TCR-alphabeta T-cell lymphoma with clinical features of primary effusion lymphoma: an autopsy case.We report an unusual case of T-cell lymphoma presenting as ascites. A 72-year-old hiv-negative woman was admitted to our hospital for abdominal discomfort associated with increasing abdominal girth over the course of 1 month. physical examination showed a tense and distended abdomen and edema of the lower extremities. There was no hepatosplenomegaly or lymphadenopathy. A computed tomographic scan of the abdomen and chest showed massive ascites and pleural effusions, but there was no evidence of tumor masses or lymph node enlargement. The cytospin prepared from the peritoneal fluid was hypercellular and composed of a population of monotonous, large cells containing fine chromatin. No herpesvirus-8 (HHV-8) dna was detected by polymerase chain reaction in the cells. immunohistochemistry showed the neoplastic cells to be CD3 , CD4, CD7 . CD8-, CD34-, CD56, and TCR-alphabeta . Repeated cytogenetic studies showed common abnormalities of del(1) (p11p22), i(7)(ql0), and t(11:14)(q23;q11). The morphologic and immunologic findings were suggestive of peripheral T-cell lymphoma (PTCL), unspecified. This case suggests that some PTCLs with clonal chromosomal aberrations can exhibit peculiar serosal spreading in the absence of HHV-8 infection.- - - - - - - - - - ranking = 2.622641509434keywords = e (Clic here for more details about this article) |
140/1044. Chemical pleurodesis for hepatic hydrothorax.BACKGROUND: ascites can occur after hepatic diseases causing dyspnea, coughing and pain. When associated with pleural effusion it can also increase respiratory distress. In a bibliographic survey hydrothorax has been observed in up to 20% of the patients and the kind of treatment is still being discussed. OBJECTIVE: This case report shows the occurrence of a large volume of ascites and pleural effusion in a cirrhotic patient and his treatment. methods: Report the case of a patient with hepatic cirrhosis due to chronic alcoholism and massive pleural effusion and ascites. He was submitted to several pleural paracenteses without success. Scintigraphy showed the presence of ascites and confirmed a possible pleuroperitoneal communication. The thoracic surgery group was called and after evaluation it was decided to submit the patient to a pulmonary decortication and chemical pleurodesis. RESULTS: These procedures were carried out with success. The pleural effusion was solved and the treatment of ascites was decided upon because the patient did not accept any surgical procedure. CONCLUSION: This treatment could be applied to patients with hydrothorax who could not be submitted to a liver transplantation.- - - - - - - - - - ranking = 2.4716981132075keywords = e (Clic here for more details about this article) |
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