• Title/Summary/Keyword: ascites

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Successful use of a mesocaval shunt to treat refractory ascites in a chronic pancreatitis induced portal vein thrombosis

  • Souradeep Dutta;Bishal Pal;Duvuru Ram;Sreevathsa Kadaba Shyamprasad;Vishnu Prasad Nelamangala Ramakrishnaiah
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.2
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    • pp.204-209
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    • 2022
  • The state of intense peripancreatic inflammation in chronic pancreatitis can give rise to various vascular complications such as venous thrombosis and arterial pseudoaneurysms. Due to its intimate location with the pancreas, spleno-mesenteric-portal axis suffers the greatest blunt of thrombotic complications. Treatment modalities for such cases of chronic portal vein thrombosis have always been controversial and challenging. Medical management with anticoagulants is both risky and unsatisfactory due to presence of varices, hypersplenism, and persistence of the inflammatory pathology. Although endovascular techniques have been tried in various case reports, there are definite anatomical challenges in cases of long segment porto-mesenteric thrombosis with massive ascites. Surgical shunts have been historically described for cirrhotic and non-cirrhotic portal hypertensive patients. However, its use in patients with refractory ascites due to chronic pancreatitis induced portal vein thrombosis has not been reported in the medical literature. Here, we present a case of an extensive portal vein thrombosis with massive refractory ascites in a patient with alcohol-induced chronic pancreatitis successfully treated with a surgical mesocaval shunt using an interposition small diameter graft.

A Canine Lymphoma Patient Diagnosed by the Cytologic Examination of Transudative Ascites (누출액성 복수의 세포학적 검사로 진단된 림프종 1예)

  • 배보경;김채욱;최을수;이창우
    • Journal of Veterinary Clinics
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    • v.21 no.2
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    • pp.194-196
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    • 2004
  • A 12-year old neutered male Yorkshire terrier dog was presented to the Veterinary Medical Teaching Hospital of Seoul National University with a history of chronic intermittent diarrhea, vomiting, anorexia and weight loss of 2-months duration. On presentation, he was very cachexic and had ascites. Abnormal findings on a complete blood count and chemistry profile included mild anemia, leukocytosis, panhypoproteinemia, hypocholesterolemia, decreased blood urea nitrogen (BUN) and increased serum bile acids. Radiographic findings indicated microhepatica. Peritoneal fluid analysis was consistent with transudates (total protein < 2.5 g/dl, total nucleated cell count = 2,200/ul) and cytologic examination of the fluid revealed neoplastic lymphoblasts. From these findings hepatic dysfunction and protein-losing enteropathy were attributable to abdominal lymphoma. This case suggests that cytologic examination is important in diagnosing underlying diseases of ascites, even if it is transudative effusion.

Intrapleural or Intraperitoneal Lobaplatin for Treatment of Patients with Malignant Pleural Effusion or Ascites

  • Huang, Xin-En;Wei, Guo-Li;Huo, Jie-Ge;Wang, Xiao-Ning;Lu, Yan-Yan;Wu, Xue-Yan;Liu, Jin;Xiang, Jin;Feng, Ji-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2611-2614
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    • 2013
  • Aims: To explore efficacy and side effects of intrapleural or intraperitoneal lobaplatin for treating patients with malignant pleural or peritoneal effusions. Methods: Patients in Jiangsu Cancer Hospital and Research Institute with cytologically confirmed solid tumors complicated with malignant pleural effusion or ascites were enrolled into this study. Lobaplatin (20-30 $mg/m^2$) was intrapleurally or intraperitoneally infused for patients with malignant pleural effusion or ascites. Results: From 2012 to 2013, intrapleural or intraperitonea lobaplatin was administered for patients with colorectal or uterus cancer who were previous treated for malignant pleural effusion or ascites. Partial response was achieved for them. Main side effects were nausea/vomiting, and bone marrow suppression. No treatment related deaths occurred. Conclusion: Intrapleural or intraperitoneal infusion of lobaplatin is a safe treatment for patients with malignant pleural effusion or ascites, and the treatment efficacy is encouraging.

A Case of Right Pleural Effusion in Liver Cirrhosis without Ascites (복수가 동반되지 않은 간경변증 환자에서 발생한 우측성 흉막액 저류 1예)

  • Yoon, Jin;Kim, Eung-Jin;Kim, Soon-Hye;Koh, Kwang-Kon;Kim, Moon-Jae;Chung, Won-Jae;Cho, Chul-Ho;Shin, Yong-Woon;Park, Chan-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.3
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    • pp.261-265
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    • 1992
  • Pleural effusion due to hepatic cirrhosis and ascites is well known. But rarely a pleural effusion may develop in a cirrhotic patient in the absence of detectable ascites. The differential diagnosis of a right-sided transudative pleural effusion in a patient with chronic liver disease with or without ascites includes congestive heart failure and nephrotic syndrome. These diseases are usually ruled out with standard clinical tests. Patients with hepatic hydrothorax should be treated with fluid restriction, diuretics and the correction of hypoalbuminemia. Patients with severe symptoms due to refractory hepatic hydrothorax might benefit from pleural sclerosis and surgical closure of diaphragmatic defect. We experienced a case of right-sided pleural effusion in liver cirrhosis without ascites.

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A Case Report of Ascites in Liver cirrhosis with Herbal Prescription (복수 동반 간병변 환자의 평위산(平胃散) 합(合) 위령탕가미방 투여 호전 1례)

  • Kim, Jin-Won;Jeong, Byeong-Ju;Woo, Sung-Ho;Shim, Hyo-Ju;Na, Eu-Jin;Kim, Yong-Ho;Seo, Ho-Seok;Lee, Won-Hui;Kim, Byung-Chul
    • The Journal of Internal Korean Medicine
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    • v.27 no.4
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    • pp.962-968
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    • 2006
  • Background : Liver cirrhosis is a disease of the liver in which normal cells are replaced by scar tissue. This condition results in the failure of the liver to perform many of its usual functions. Liver cirrhosis includes ascites, jaundice, portal hypertension, varices etc. Objectives : This study was to see if there is a decrease in ascites of liver cirrhosis to under acupuncture and herbal treatment to test their validity. Methods : Measuring the response to treatment of ascites by giving pyengwie-san hap wieryungtang gamibang and treating the patient with acupuncture, these clinical symptoms were observed: weight, abdominal circumference, abdominal SONO, chest X-ray, and lab findings. Results : Over 18 days the daily average loss of weight and abdominal circumference 0.43kg and 0.56cm, respectively. Lab findings of liver functions showed improvement. Conclusions : This report shows a role for acupuncture and herbal treatment for treating ascites in liver cirrhosis.

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A Case Study of a Patient Who Discontinued Diuretics due to Hyponatremia and Was Treated with Korean Medicine for Ascites (저나트륨혈증으로 이뇨제를 중단한 간경변 환자 복수에 대한 한방치료 1례)

  • In-hu, Bae;Geun Young, Kim;Seong Hoon, Jeong;Ki-Ho, Cho;Sang-Kwan, Moon;Woo-Sang, Jung;Seungwon, Kwon
    • The Journal of Internal Korean Medicine
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    • v.43 no.6
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    • pp.1198-1207
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    • 2022
  • Objectives: This study examined a case of an 80-year-old woman with extensive ascites and hypervolemic hyponatremia due to decompensated liver cirrhosis. Methods: The patient was first treated with a diuretic to treat her ascites. However, during hospitalization, she developed hypervolemic hyponatremia due to liver cirrhosis. Therefore, we discontinued the diuretic and treated her with Korean herbal medicine (Insamyangyoung-tang with Oryeong-san). We measured her abdominal circumference, followed by radiography, to evaluate the effect of Korean herbal medicine. Result: We treated the patient only with Korean medicine and without diuretics, and her ascites was successfully reduced. No recurrence was observed. Conclusion: Korean herbal medicine can be used as an adjuvant therapy for patients with ascites and hyponatremia.

Effects of Dietary L-carnitine Supplementation on Growth Performance, Organ Weight, Biochemical Parameters and Ascites Susceptibility in Broilers Reared Under Low-temperature Environment

  • Wang, Y.W.;Ning, D.;Peng, Y.Z.;Guo, Y.M.
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.2
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    • pp.233-240
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    • 2013
  • The objective of this study was to investigate the effects of L-carnitine on growth performance, organ weight, biochemical parameters of blood, heart and liver, and ascites susceptibility of broilers at different ages reared under a low-temperature environment. A total of 420 1-d-old male Ross 308 broilers were randomly assigned to two dietary treatments with fifteen replicates of fourteen broilers each. Treatment diets consisted of L-carnitine supplementation at levels of 0 and 100 mg/kg. At 11-d of age, low temperature stress was used to increase ascites susceptibility. Blood, heart and liver samples were collected at different ages for analysis of boichemical parameters. The results showed that, there was no significant difference in growth performance with L-carnitine supplementation, but the mortality due to ascites was significantly decreased. Dietary L-carnitine supplementation significantly reduced heart index (HI) and ascites heart index (AHI) on d 21, lung index (LUI) on d 35 and liver index (LI) on d 42. The broilers fed diets containing L-carnitine had significantly lower red blood cell counts (RBC), hemoglobin (HGB) concentration and hematocrit (HCT) on d 42. Dietary L-carnitine supplementation significantly reduced malondialdehyde (MDA) content of heart tissue on d 21 and 35, and significantly increased total superoxide dismutase (T-SOD) and Glutathione peroxidase (GSH-Px) activity of the heart on d 21 and 42. L-carnitine supplementation significantly reduced serum triglyceride (TG) content on d 28 and 35 and serum glucose (GLU) on d 35 and 42, and significantly increased serum total protein (TP) and globulin (GLO) content on d 42. L-carnitine supplementation significantly enhanced liver succinodehydrogenase (SDH), malic dehydrogenase (MDH) and $Na^+$-$K^+$-ATPase activity on d 28, and tended to reduce the lactic acid (LD) level of liver on d 35 (p = 0.06). L-carnitine supplementation significantly reduced serum uric acid (UA) content on d 28, 35 and 42. Based on the current results, it can be concluded that dietary L-carnitine supplementation reduced organ index, red blood cell counts and hematocrit, enhanced antioxidative capacity of the heart, enhanced liver enzymes activity involved in tricarboxylic acid cycle, and reduced serum glucose and triglyceride. Therefore, it is suggested that L-carnitine can potentially reduce susceptibility and mortality due to ascites.

Comparison of Clinical and Radiologic Findings Between Perforated and Non-Perforated Choledochal Cysts in Children

  • Yu Jin Kim;Soo-Hyun Kim;So-Young Yoo;Ji Hye Kim;Soo-Min Jung;Sanghoon Lee;Jeong-Meen Seo;Sung-Hoon Moon;Tae Yeon Jeon
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.271-279
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    • 2022
  • Objective: To compare the clinical and radiologic findings between perforated and non-perforated choledochal cysts in children. Materials and Methods: Fourteen patients (mean age ± standard deviation, 1.7 ± 1.2 years) with perforated choledochal cysts (perforated group) and 204 patients (3.6 ± 3.8 years) with non-perforated choledochal cysts (non-perforated group) were included between 2000 and 2019. All patients underwent choledochal cyst excision after ultrasound, CT, or MR cholangiopancreatography. Relevant data including demographics, clinical symptoms, laboratory findings, imaging findings, and outcomes were analyzed. Statistical differences were compared using the Mann-Whitney U test and Fisher's exact test. Results: Choledochal cyst perforation occurred only in children under the age of 4 years. Acute symptoms, including fever (p < 0.001), were more common in the perforated group than in the non-perforated group. High levels of white blood cells (p = 0.004), C-reactive protein (p < 0.001), and serum amylase (p = 0.002), and low levels of albumin (p < 0.001) were significantly associated with the perforated group. All 14 patients with perforated choledochal cysts had ascites, whereas only 16% (33/204) of patients in the non-perforated group had ascites (p < 0.001). In the subgroup of patients who had ascites, a large amount of ascites (p = 0.001), increase in the amount of ascites in a short time (p < 0.001), complex ascites (p < 0.001), and perihepatic pseudocysts (p < 0.001) were more common in the perforated group than in the non-perforated group. Conclusion: Children with perforated choledochal cysts have characteristic clinical and radiologic findings compared to those with non-perforated choledochal cysts. In young children with choledochal cysts, perforation should be differentiated in cases with acute symptoms, laboratory abnormalities, and characteristic ascites findings.

A Case of Urinary Ascites with Urinoma Secondary to Ureteropelvic Junction Obstruction in a Neonate (신생아에서 신우요관이행부 폐색으로 인해 발생한 요낭종 및 요성복수 1례)

  • Choi, Min-Seon;Kim, Eun-Young;Park, Sang-Kee;Kim, Dong-Hyun;Jung, Hyun-Jin
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.379-382
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    • 2011
  • Spontaneous intraperitoneal extravasation of urine is rare. Perirenal urinoma may develop when obstruction to urinary flow creates sufficient back pressure to produce extravasation of urine. Urinary ascites most commonly indicate a disruption to the integrity of the urinary tract. We report a case of urinary ascites with urinoma resulting from an ureteropelvic junction obstruction in a neonate.

Chunggangunbi-tang-gamibang's Effect on Alcoholic Liver Cirrhosis with Ascites (청간건비탕가미방(淸肝健脾湯加味方)으로 복수(腹水)를 동반한 알코올성 간경변(肝硬變) 환자(患者) 치험 1례)

  • Jeong, Eun-Woo;Cho, Yoon-Sung;Kim, Hyun-Sik;Kim, So-Yeon;Lee, Sang-Kwan
    • Herbal Formula Science
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    • v.15 no.2
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    • pp.161-169
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    • 2007
  • We applied Chunggangunbi-tang-gamibang to a 64 year-old male patient who had alcoholic liver cirrhosis with ascites. Chunggangunbi-tang-gamibang has been used to treat alcoholic liver disease and because of its beneficial effects. The patient with the disease expected several symptoms induced by Alcoholic liver cirrhosis, and we diagnosised differentiation of symptoms, using Chunggangunbi-tang-gamibang while removing dampness through diuresis and invigorating the spleen. After medication we could find remarkable effects on clinical symptoms, blood test results and abdomen ultrasonographic images. From this case, it is thought that using Chunggangunbi-tang-gamibang is very effective to improve the symptom of alcoholic liver cirrhosis with ascites.

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