1/66. Incarceration of umbilical hernia following transjugular intrahepatic portosystemic shunt for the treatment of ascites.Transjugular intrahepatic portosystemic shunt (TIPS) is an effective therapy for patients with medically refractory ascites. Many patients with refractory ascites have umbilical herniation. Incarceration of umbilical hernia has been reported following diuresis, paracentesis, and peritoneovenous shunting. We report 2 cases of umbilical hernia incarceration following resolution of ascites after TIPS.- - - - - - - - - - ranking = 1keywords = ascites (Clic here for more details about this article) |
2/66. Vasculitic small bowel perforation masquerading as spontaneous bacterial peritonitis in a patient with decompensated liver disease.We report on a young patient with decompensated alcohol-induced liver disease (child-Pugh score C) who presented with clinical, biochemical and radiological evidence suggestive of spontaneous bacterial peritonitis. She was however subsequently found to have multiple small bowel perforations, which were diagnosed only at laparotomy. The histology of the bowel showed evidence of vasculitis. This case illustrates two important points. Firstly, even if a patient has all the prerequisites to develop spontaneous bacterial peritonitis, a secondary cause of peritonitis (eg. bowel perforation or intra-abdominal abscess) must always be considered as a differential diagnosis and a repeat ascitic tap is mandatory after 48 h of antibiotic therapy to confirm a decrease in the white cell count. Secondly, it shows the rare co-existence of alcoholic liver disease and vasculitis.- - - - - - - - - - ranking = 1.9046868704906keywords = peritonitis (Clic here for more details about this article) |
3/66. Case report: spontaneous peritonitis caused by candida albicans.We report a 40-year-old man with decompensated alcoholic liver cirrhosis, who developed spontaneous peritonitis caused by candida albicans after complete recovery from a recent episode of acute pancreatitis. The patient was successfully treated with amphotericin b. A search of the literature showed that this is the fourth reported case of spontaneous peritonitis caused by candida albicans.- - - - - - - - - - ranking = 1.6325887461348keywords = peritonitis (Clic here for more details about this article) |
4/66. Acquired cutaneous lymphangiectasia in a patient with cirrhotic ascites.BACKGROUND: Lymphangiectasia results from acquired dilation of lymphatic vessels. Areas of skin affected by obstruction or destruction of lymphatic drainage are said to be prone to the development of lymphangiectasia. Cirrhosis is a cause of alterations of lymph flow. methods: Case report. RESULTS: We report a case of acquired, late-onset, lymphangiectasia associated with alcoholic hepatic cirrhosis. Lesions were scattered over the right, lower, anterior abdominal wall, a region that is drained by a common group of lymphatic vessels that were probably disordered. CONCLUSION: We think that this is the first reported case of lymphangiectasia associated with altered lymph flow in cirrhosis and ascites.- - - - - - - - - - ranking = 0.71428571428571keywords = ascites (Clic here for more details about this article) |
5/66. Left-sided hepatic hydrothorax with ascites.hydrothorax has long been recognised as a complication of cirrhosis, but it is seen in only a few patients, mostly on the right side. We report an unusual case of massive left-sided hydrothorax complicating cirrhosis with ascites, where pleuro-peritoneal communication was demonstrated on the left side by radionuclide scanning.- - - - - - - - - - ranking = 0.71428571428571keywords = ascites (Clic here for more details about this article) |
6/66. Successful treatment of hepatic hydrothorax with octreotide.Hepatic hydrothorax is a rare complication of cirrhosis. Controlling ascites formation is the goal of therapy. We report the case of an adult patient presenting with alcoholic cirrhosis who developed first a symptomatic hydrothorax, refractory to diuretics and fluid and sodium restriction, and then an hepatorenal syndrome. Treatment consisted of chest tube insertion and 5 days' intravenous infusion of octreotide. Complete clinical and biological data were reviewed. octreotide administration resulted in an increased urinary outflow and sodium output, concomitant with improved renal function. The patient has been free of symptoms after discharge from hospital for a follow-up period of 5 months. This observation raises interesting issues regarding the possible utility of splanchnic vasoconstrictors, reducing portal hypertension, in the treatment of refractory hepatic hydrothorax.- - - - - - - - - - ranking = 0.14285714285714keywords = ascites (Clic here for more details about this article) |
7/66. Primary effusion lymphoma in an hiv-negative patient with no serologic evidence of Kaposi's sarcoma virus.Primary effusion lymphoma (PEL) is a newly described high-grade B cell lymphoma which develops in association with Kaposi's sarcoma-associated herpesvirus (KSV) in human immunodeficiency virus (hiv)-infected individuals. We hereby describe a very unusual presentation of PEL that developed in the abdominal cavity of an hiv negative, KSV negative patient with a 1-year history of refractory ascites due to alcohol-related liver cirrhosis. Possible factors aiding lymphomagenesis in the cirrhotic state are discussed.- - - - - - - - - - ranking = 0.14285714285714keywords = ascites (Clic here for more details about this article) |
8/66. salmonella dublin infection: a rare cause of spontaneous bacterial peritonitis and chronic colitis in alcoholic liver cirrhosis.salmonella dublin is a veterinary pathogen which rarely causes human illness, although reported human isolates have increased over the past two decades. This serovar of salmonella is unusually invasive and life-threatening, although the clinical pattern of human infection is not well known. We describe a 51-year-old cirrhotic patient who presented with severe liver failure, chronic diarrhoea and left-sided segmental colitis. Radiological and endoscopic findings suggested Crohn's colitis. During the hospital stay he developed a spontaneous bacterial peritonitis (SBP) and S. dublin was isolated in the ascitic fluid. Our report supports the view that this salmonella serovar should be kept in mind as a rare cause of SBP in cirrhotic patients, especially in those cases with chronic colitis resembling Crohn's disease.- - - - - - - - - - ranking = 1.360490621779keywords = peritonitis (Clic here for more details about this article) |
9/66. ascites due to hypothyroidism in a patient with alcoholic cirrhosis.myxedema is the cause of ascites in less than 1% of new-onset ascites cases, where as only 4% of patients with hypothyroidism present ascites. When ascites is the first manifestation of thyroid insufficiency, there is usually a delay in diagnosis. We report here a case of myxedema ascites occurring in a patient with alcoholic cirrhosis, that was first thought to be the cause of the ascites, and review the features of 48 cases previously reported. Some clinic and analytical findings that have been commonly reported, are the long duration of the ascites before diagnosis, the prompt response (with resolution of ascites) to thyroid replacement treatment, a high total protein concentration in ascites fluid, white moderate white blood cell counts and a lymphocyte predominance. serum-ascites albumin gradient has been postulated to be high in myxedema ascites, but we believe this has been studied in too few cases thus far, to be conclusive.- - - - - - - - - - ranking = 1.5714285714286keywords = ascites (Clic here for more details about this article) |
10/66. 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 = 0.57142857142857keywords = ascites (Clic here for more details about this article) |
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