• Title/Summary/Keyword: ascites

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Simultaneous chylothorax and chylous ascites (암죽가슴증 및 암죽복수의 동시발생)

  • Jang, Tae Soo;Jeong, In Beom;Cho, Do Yeun;Kang, Sung Ju;Kwon, Oh Jung
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.265-269
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    • 2017
  • Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.

Plasma D-dimer Can Effectively Predict the Prospective Occurrence of Ascites in Advanced Schistosomiasis Japonica Patients

  • Wu, Xiaoying;Ren, Jianwei;Gao, Zulu;Xu, Yun;Xie, Huiqun;Li, Tingfang;Cheng, Yanhua;Hu, Fei;Liu, Hongyun;Gong, Zhihong;Liang, Jinyi;Shen, Jia;Liu, Zhen;Wu, Feng;Sun, Xi;Niu, Zhongzheng;Ning, An
    • Parasites, Hosts and Diseases
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    • v.55 no.2
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    • pp.167-174
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    • 2017
  • China still has more than 30,000 patients of advanced schistosomiasis while new cases being reported consistently. D-dimer is a fibrin degradation product. As ascites being the dominating symptom in advanced schistosomiasis, the present study aimed to explore a prediction model of ascites with D-dimer and other clinical easy-achievable indicators. A case-control study nested in a prospective cohort was conducted in schistosomiasis-endemic area of southern China. A total of 291 patients of advanced schistosomiasis were first investigated in 2013 and further followed in 2014. Information on clinical history, physical examination, and abdominal ultrasonography, including the symptom of ascites was repeatedly collected. Result showed 44 patients having ascites. Most of the patients' ascites were confined in the kidney area with median area of $20mm^2$. The level of plasma D-dimer and pertinent liver function indicators were measured at the initial investigation in 2013. Compared with those without ascites, cases with ascites had significantly higher levels of D-dimer ($0.71{\pm}2.44{\mu}g/L$ vs $0.48{\pm}2.12{\mu}g/L$, P=0.005), as well ALB (44.5 vs 46.2, g/L) and Type IV collagen (50.04 vs $44.50{\mu}g/L$). Receiver operating characteristic curve analyses indicated a moderate predictive value of D-dimer by its own area under curve (AUC) of 0.64 (95% CI: 0.54-0.73) and the cutoff value as $0.81{\mu}g/L$. Dichotomized by the cutoff level, D-dimer along with other categorical variables generated a prediction model with AUC of 0.76 (95% CI: 0.68-0.89). Risks of patients with specific characteristics in the prediction model were summarized. Our study suggests that the plasma D-dimer level is a reliable predictor for incident ascites in advanced schistosomiasis japonica patients.

Effects of Cold Stress on Broiler Performance and Ascites Susceptibility

  • Ipek, A.;Sahan, U.
    • Asian-Australasian Journal of Animal Sciences
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    • v.19 no.5
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    • pp.734-738
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    • 2006
  • The present study was conducted to determine the effect of cold stress on broiler performance and ascites susceptibility. Male chicks were obtained from a commercial strain of broiler breeders. The trial was divided into two treatments (control and cold stress groups). Ascites was induced in broiler chickens in the trial by exposing the chickens to low temperature (Ta) and by supplying a pelleted diet. The two experimental treatments consisted of: 1) Control group, $33.3^{\circ}C$ the $1^{st}$ wk, $30.2^{\circ}C$ the $2^{nd}$ wk, and $27.5^{\circ}C$ the $3^{rd}$ wk. 2) Cold stress group, $29.0^{\circ}C$ the $1^{st}$ wk, $26.4^{\circ}C$ the $2^{nd}$ wk, and $23.1^{\circ}C$ the $3^{rd}$ wk. From the end of the $3^{rd}$ wk all broilers were reared to 6 wk of age at a constant temperature of $21^{\circ}C$. There was significant difference in live BW during wk 1 to 5. The control group was consistently the heaviest; however, at 6 wk of age, both groups weighed the same. Body weight gain up to 3 wk was significantly decreased by cold stress. During wk 3 and 6 the chicks in the cold stress group had greater BW gain compared with the chicks in the control group. There were significant differences in mortality due to ascites between the groups. During wk 3 and 6 the cold stress group exhibited the most ascites mortality (9.52%) when compared with the control group (1.90%). At 5 wk of age cold stress condition caused significant changes in packed cell volume (PCV), hemoglobin (Hb) and red blood cell counts (RBC). Right ventricle weight was significantly heavier in the cold stress group than the control. There were also significant differences in right ventricle/total ventricle (RV/TV) ratios at 5 wk. the right ventricle/total ventricle ratios in the cold stress group was higher (0.25) than the control group (0.20). It was concluded that, fast growth and cold temperatures are the primary triggers for ascites during commercial broiler production.

A case of post-operative chylous ascites after a splenorenal shunt operation in a child with congenital hepatic fibrosis (선천성 간섬유화증에서 비-신장 문합수술 후에 발생한 소아의 유미성 복수증 1례)

  • Yoon, Jong Hyung;Yang, Hye Ran;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1106-1110
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    • 2006
  • Chylous ascites is a rare condition caused by various diseases and conditions that interfere with the abdominal or retroperitoneal lymphatics, and uncommonly it can manifest as a post-operative complication after abdominal, retroperitoneal or mediastinal surgery. Chylous ascites can be diagnosed by a high triglyceride content in ascites. The authors experienced a 5-year-old girl with congenital hepatic fibrosis who presented with chylous ascites after a splenorenal shunt operation, who was successfully managed by fasting and total parenteral nutrition, followed by a lipid-free diet with medium chain triglyceride supplementation. Here, the authors report this case of post-operative chylous ascites after a splenorenal shunt (Warren shunt) operation with a review of the pertinent literature.

Radionuclide Peritoneal Scintigraphy in Patients with Ascites and Pleural Effusion (방사성핵종 복막촬영술을 이용한 복수에 동반된 수흉의 감별 진단)

  • Lee, Jae-Tae;Lee, Kyu-Bo;Whang, Kee-Suk;Kim, Gwang-Weon;Chung, Byung-Cheon;Cho, Dong-Kyu;Chung, Joon-Mo
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.279-285
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    • 1990
  • Simultaneous presence of ascites and pleural effusion has been documented in patients with cirrhosis of the liver, renal disease, Meigs' syndrome and in patients undergoing peritoneal dialysis. Mechanisms proposed in the formation of pleural effusion in most of the above diseases are lymphatic drainage and diaphragmatic defect. But sometimes, hepatic hydrothoraxes in the absence of clinical ascites and pleural effusion secondary to pulmonary or cardiac disease are noted. It is not always possible to differentiate between pleural effusion caused by transdiaphragmatic migration of ascites and by other causes based soly on biochemical analysis. Authors performed radionuclide scintigraphy after intraperitoneal administration of $^{99m}Tc-labeled$ colloid in 23 patients with both ascites and pleural effusion in order to discriminate causative mechanisms responsible for pleural effusion. Scintigraphy demonstrated the transdiaphragmatic flow of fluid from the peritoneum to pleural cavities in 13 patients correctly. In contrast, in 5 patients with pleural effusion secondary to pulmonary, pleural and cardiac diseases, radiotracers fail to traverse the diaphragm and localize in the pleural space. Ascites draining to mediastinal lymph nodes and blocked passage of lymphatic drainage were also clarified, additionaly. Conclusively, radionuclide peritoneal scintigraphy is an accurate, rapid and easy diagnostic tool in patients with both ascites and pleural effusion. It enables the causes of pleural effusion to be elucidated, as well as providing valuable information required when determining the appropriate therapy.

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Insulin-Like Growth Factors and Their Binding Proteins in Tumors and Ascites of Ovarian Cancer Patients: Association With Response To Neoadjuvant Chemotherapy

  • Yunusova, Natalia V;Villert, Alisa B;Spirina, Liudmila V;Frolova, Alena E;Kolomiets, Larisa A;Kondakova, Irina V
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5315-5320
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    • 2016
  • Purpose: Tumor cell growth and sensitivity to chemotherapy depend on many factors, among which insulin-like growth factors (IGFs) may play important roles. The aim of the present study was to evaluate the levels of insulin-like growth factors (IGFs) and IGF binding proteins (IGFBPs) in primary tumors and ascites as predictors of response to neoadjuvant chemotherapy in ovarian cancer (OC) patients. Materials and Methods: Tumor tissue samples and ascitic fluid were obtained from 59 patients with advanced OC. The levels of IGF-I, IGF-II, IGFBP-3, IGFBP-4 and PAPP-A were determined using ELISA kits. Taking into account the data on expression of these IGF-related proteins and outcome, logistic regression was performed to identify predictors of response to neoajuvant chemotherapy. Results: Human ovarian tumors expressed IGFs, IGFBP-3, IGFBP-4 and PAPP-A and these proteins were also present in ascites fluid and associated with its volume. IGFs and IGFBPs in ascites and soluble PAPP-A might play a key role in ovarian cancer progression. However, levels of proteins of the IGF system in tumors were not significant predictors of objective clinical response (oCR). Univariate analysis showed that the level of IGF-I in ascites was the only independent predictor for oCR. Conclusion: The level of IGF-I in ascites was shown to be an independent predictor of objective clinical response to chemotherapy for OC patients treated with neoadjuvant chemotherapy and debulking surgery.

Effects of dietary glutamine and arginine supplementation on performance, intestinal morphology and ascites mortality in broiler chickens reared under cold environment

  • Abdulkarimi, Rahim;Shahir, Mohammad Hossein;Daneshyar, Mohsen
    • Asian-Australasian Journal of Animal Sciences
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    • v.32 no.1
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    • pp.110-117
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    • 2019
  • Objective: An experiment was conducted to evaluate the effects of dietary glutamine (Gln) and arginine (Arg) supplementation on performance, intestinal morphology and ascites mortality in broilers. Methods: A total of 675 day old chicks were randomly allocated to 9 experimental groups in a $3{\times}3$ factorial arrangement based on a completely randomized design with 5 replicates of 15 chicks. Three levels of dietary Gln (0%, 0.5%, and 1%) and Arg (100%, 130%, and 160% of Ross recommendation) supplementation were used in ascites inducing condition ($15^{\circ}C{\pm}1^{\circ}C$) from 7 to 42 days of age. Results: Dietary supplementation of Gln increased body weight gain during grower, finisher and total periods (p<0.05) and increased feed intake during total period. Ascites mortality was decreased by Gln supplementation (p<0.05). Gln supplementation increased the villus height (VH) and crypt depth (CD) in duodenum and jejunum (p<0.05). Arg supplementation decreased CD in duodenum and jejunum, and increased ileum villus width (VW) and also VH/CD ratio in duodenum and jejunum (p<0.05). Both Gln and Arg increased the goblet cell number (GCN) in duodenum whereas Gln supplementation decreased GCN in jejunum and ileum (p<0.05). The $Gln{\times}Arg$ interaction were observed for right ventricle (RV)/total ventricular (TV) ratio, VH, VW, CD, VH/CD. Conclusion: It was concluded that dietary 0.5% Gln alone or along with 130% Arg of Ross requirement, improve the intestinal morphology and performance and hence decrease the ascites mortality in broiler chickens with cold induced ascites.

CONCEPT AND MANAGEMENT OF ISTISQĀ' (OEDEMA) IN UNANI SYSTEM OF MEDICINE

  • Khan, Khalid Ali;Zakir, Mohammad;Khan, Shahid Ali;Khan, Rashid Ali
    • CELLMED
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    • v.11 no.1
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    • pp.3.1-3.6
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    • 2021
  • Ascites is the accumulation of fluid in the peritoneal cavity, and it is generally allied with liver disease like cirrhosis of the liver. The ascites is commonly associated with liver cirrhosis, malignancy, or cardiovascular disease today. The liver cirrhosis is the most significant cause of ascites in developed countries as per the available data. In the modern medicine system, the treatment includes the restriction of sodium intake, use of diuretics, and paracentesis done in severe cases. There are many side effects of synthetic chemical diuretics, and their long-term use is not recommended. The alternative medicine like Unani system of medicine provides natural diuretics and drugs which also have protective effects on kidney, liver and other internal organs. It is well known in all drug systems that the prognosis is poor in ascites, but the use of Unani herbal medicines can minimize the side effects caused by synthetic chemical diuretics. The natural herbs used for the management of ascites have fewer side effects as compared to synthetic drugs. The natural drugs can be used for longer duration and provide some dietary supplement which improves the quality of life. This review addressed the thorough treatment of ascites by natural diet and medications.

Glue Embolization of Lymphopseudoaneurysm for Chylous Ascites after Retroperitoneal Surgery

  • Lyo Min Kwon;Saebeom Hur;Chang Wook Jeong;Hwan Jun Jae;Jin Wook Chung
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.376-383
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    • 2021
  • Objective: To assess the safety and efficacy of lymphopseudoaneurysm (LPA) glue (n-butyl cyanoacrylate [NBCA]) embolization in the management of chylous ascites after retroperitoneal surgery. Materials and Methods: A retrospective analysis from January 2014 to October 2018 was performed in six patients (4 females and 2 males; mean age, 45.3 ± 14.2 years; range, 26-61 years) who underwent LPA embolization for chylous ascites developing after retroperitoneal surgery involving the perirenal space (four donor nephrectomies, one partial nephrectomy, and one retroperitoneal lymphadenectomy). After placing a percutaneous drainage catheter into the LPA or adjacent lymphocele, embolization was performed by filling the LPA itself with a mixture of glue and Lipiodol (Guerbet). Results: Daily drainage from percutaneously placed drains exceeded 300 mL/day despite medical and surgical treatment (volume: mean, 1173 ± 1098 mL; range, 305-2800 mL). Intranodal lymphangiography was performed in four of the six patients and revealed leakage in 2 patients. Percutaneous embolization of the LPA was successful in all patients using an NBCA and Lipiodol mixture in a ratio of 1:1-1:2 (volume: mean, 4.3 ± 1.1 mL; range, 3-6 mL). Chylous ascites was resolved and the drainage catheter was removed in all patients within 4 days after the procedure (mean, 2.0 ± 1.8 days; range, 0-4 days). No procedure-related complications or recurrence of chylous ascites occurred during a mean follow-up period of 37.3 months (range, 21.1-48.4 months). Conclusion: Glue embolization of LPA has the potential to be a feasible and effective treatment method for the management of chylous ascites after retroperitoneal surgery.

Ascitic Fluid Analysis for the Differentiation of Malignancy-Related and Nonmalignant Ascites (악성 복수와 비악성 복수의 감별을 위한 복수액 분석)

  • Lee, Eun-Young;Kim, Byeoung-Deok;Choi, Jae-Hyuk;Lee, Sang-Yeop;Ryu, Hun-Mo;Lee, Kyung-Hee;Hyun, Myung-Soo
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.76-84
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    • 1999
  • The differentiation between malignancy-related ascites(MRA) and non-malignant ascites (NMA) is important for further diagnostic and therapeutic purposes. Although many parameters were investigated, none has provided a complete distinction between MRA and NMA. We investigated several ascitic fluid parameters to determine the differential power, and to differentiate malignant-related from nonmalignant-related ascites with a sequence of sensitive parameters followed by specific parameters. For the present study, 80 patients with ascites were divided into two groups: MRA and NMA, The MRA group was consisted of 27 patients with proven malignancy by image study, biopsy, and follow up: 21 of these patients had peritoneal carcinomatosis, but the remaining 6 showed no evidence of peritoneal carcinomatosis. The NMA group was consisted of 53 patients with no evidence of malignancy: among these patients, one had SLE, and others had liver cirrhosis, The samples of blood and ascites were obtained simultaneously, and then the levels of ascites cholesterol, CEA. protein and LDH, cytology, albumin gradient, ascites/serum concen-tration ratios of LDH(LDH A/S), and ascites/serum concentration ratios of protein(protein A/S) were measured. Applying cut-off limits for determined parameters, we estimated the diagnostic efficacy of each parameter, Among the eight parameters investigated, ascites fluid cholesterol yielded the best sensitive value of 93%(cut-off value 30mg/dl), and cytologic examination and the protein A/S(cut-off value 0.5) showed the most specific value of 100% and 96%, respectively. Based on the above results, the diagnostic sequence with cholesterol as a sensitive parameter followed by the combination of cytologic examination and protein A/S as specific parameters, was tested in 80 patients. This diagnostic sequence identified 81.5% of patients with malignancy, and all patients with peritoneal carcinomatosis were classified as malignancy-related ascites. In spite of many limitations, this proposed diagnostic sequence may permit a cost-effective and simple differentiation of malignancy-related ascites from nonmalignant ascites.

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