Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ASCITES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 901 records · Page 50Linked to original sources
PubMed1991

Effect of marked peripheral leukocytosis on the leukocyte count in ascites.

Patients with high peripheral leukocyte counts are sometimes found to have high leukocyte counts in ascitic fluid in the presence of negative cultures. To determine if peripheral leukocytosis (greater than or equal to 20 x 10(9)/L) by itself can result in high leukocyte or neutrophil counts in ascites, 29 patients were studied. A total of 31 paracenteses were performed in these patients as soon as the high peripheral leukocyte count was determined. Culture of ascitic fluid was performed using blood-culture bottles. The mean peripheral leukocyte count was 29.3 +/- 9.3 x 10(9)/L, with a mean neutrophil count of 19.9 +/- 6.5 x 10(9)/L. The mean ascitic fluid neutrophil count was 0.064 +/- 0.054 x 10(9)/L (range, 0.007 to 0.197 x 10(9)/L). No significant correlation was found between peripheral neutrophil (or leukocyte) count and neutrophil (or leukocyte) count in ascitic fluid. Marked peripheral leukocytosis (or neutrophilia) does not seem to have an effect on the leukocyte or neutrophil count in ascitic fluid.

Ascites↗
PubMed1982

Neutrophil-mediated tumor cell destruction in cancer ascites.

Intraperitoneal injections of OK-432, originated from Group A streptococcus pyogens of human origin, were administered to 77 patients with ascites caused by cancer of the digestive tract. Complete disappearance of effusion was observed in 43 cases, its reduction in five out of 77. They received cytologic examination of ascites daily before and after OK-432 injection. One of these patients, a 77-year-old man with carcinomatous peritonitis due to gastric cancer, showed an interesting phenomenon after OK-432 injection. All adenocarcinoma cells in his ascites disappeared at least with 36 hours after OK-432 injection with increasing number of intraperitoneal neutrophils. In addition, neutrophils collected from his ascites or peripheral blood showed cytostatic effect on his ascites-derived tumor cells in vitro. His neutrophil-depleted intraperitoneal cells, however, had no significant effect on DNA synthesis of his tumor cells in vitro. OK-432 itself had no significant effect on DNA synthesis of his tumor cells in vitro. This report describes a patient in whom OK-432-induced neutrophils may play an important role in his tumor cell destruction in ascites.

Adenocarcinoma↗
PubMed1984

Control of malignant ascites by peritoneovenous shunting.

Twenty peritoneovenous shunts were inserted in 17 patients with intractable malignant ascites. The ascites was controlled without the need for further paracentesis abdominis in 13 patients. Four shunts blocked and three patients had second shunts inserted, but other complications were minor. Patients who benefited from the procedure included those with macroscopically light blood staining of the ascites and those with malignant cells in the ascitic fluid. Unless the ascites is heavily blood-stained or the patient's anticipated survival is less than 1 month, peritoneovenous shunting is indicated for the treatment of uncontrollable malignant ascites.

Actuarial Analysis↗
PubMed1989

Diagnostic accuracy of sialic acid in the diagnosis of malignant ascites.

The authors evaluated the diagnostic accuracy of sialic acid and its lipid-bound fraction in ascites and compared these tests with others (fibronectin, cholesterol) recently claimed as valuable in the differential diagnosis of ascites. Fibronectin yielded the best diagnostic accuracy (85%) with no false-positive and 37% of false-negative (10/27). The authors also found higher concentration of sialic acid in malignant ascites than in nonmalignant ascites (P less than 0.001) and, taking 300 mg/l as the cutoff value, the false-positive rate was 10% (four of 40), the false-negative rate 30% (eight of 27), and the overall diagnostic accuracy 82%, comparable to that of the fibronectin. The authors conclude that both fibronectin and sialic acid determinations in ascites may be regarded as accurate markers of neoplastic involvement of the peritoneum, although no test is useful in the ascites with hepatocellular carcinoma and cirrhosis of the liver.

Ascites↗
PubMedDate not supplied

Early diagnosis of spontaneous bacterial peritonitis: values of ascitic fluid variables.

In a search for clinical and laboratory factors that would aid in early diagnosis of spontaneous bacterial peritonitis, we identified two groups of patients with chronic liver disease and ascites: 1) 38 patients with 40 episodes of spontaneous bacterial peritonitis, and 2) 39 randomly selected patients with 40 sterile paracenteses who were matched for severity of liver dysfunction as a reference group. A variety of clinical and laboratory features were examined. The absolute lymphocyte count in peripheral blood was lower for the spontaneous bacterial peritonitis group (mean = 703/mm3 vs. 1,212/mm3, p less than 0.005). Four ascitic fluid variables, i.e., a white blood cell count of greater than or equal to 300/mm3, a polymorphonuclear leukocyte count of greater than or equal to 240/mm3, an ascitic fluid/serum LDH ratio of greater than or equal to 0.4, or an ascitic fluid/serum glucose ratio of less than or equal to 1.0, could separate the spontaneous bacterial peritonitis and reference groups with both sensitivity and specificity of greater than 70%. Although ascitic fluid total leucocyte and polymorphonuclear leucocyte counts are appropriate indicators for the early diagnosis of spontaneous bacterial peritonitis, the possibility of their false positivity should be warranted. The use of multiple tests including ascitic fluid/serum LDH and glucose ratios has better positive predictive value than a single test alone.

Adult↗
PubMed1995

A simple method for ascites concentration and reinfusion.

A rapid and simple method for ascites concentration and reinfusion was utilized to treat 103 episodes of tense ascites in 57 patients (38 men and 19 women, mean age 63 +/- 11 years). After a bedside total paracentesis, 6.06 +/- 2.87 liters of ascites were separately ultrafiltrated using a mechanical device during a mean interval of 134 +/- 88 min, and 430 +/- 368 ml of concentrate containing 39 +/- 42 g of albumin were restituted at bedside either intravenously (44 cases) or intraperitoneally (59 cases). Ultrafiltration was successfully and easily completed in all cases. Ascites concentration and reinfusion either intravenously or intraperitoneally did not adversely modify hemodynamic or renal parameters except for a transient decrease in mean arterial pressure (P < 0.05). Transitory hyponatremia and renal failure occurred in two patients. A transient decrease in platelet count and serum fibrinogen levels (P < 0.05) and pyrexia (12%) were observed only in patients reinfused intravenously. In conclusion, this new method for ascites concentration and reinfusion was effective, safe, and, with respect to traditional methods, simpler, faster and more comfortable. Therefore it is proposed for the routine management of tense ascites.

Albumins↗
PubMed1979

Pancreatic ascites: a rare complication of distal splenorenal shunt.

Ascites has become recognized as a common postoperative complication of the distal splenorenal shunt. On rare occasions the ascites has been chylous in nature. The present report is the first documented case of pancreatic ascites occurring after this operation. This complication developed in the combined setting of chronic pancreatitis and surgical trauma to the pancreas. Since the management of pancreatic ascites differs from that of cirrhotic or chylous ascites, it is recommended that this diagnosis be considered whenever a patient develops severe ascites after a distal spenorenal shunt.

Amylases↗
PubMed1990

A randomised prospective trial comparing daily paracentesis and intravenous albumin with recirculation in diuretic refractory ascites.

We report a randomised trial in 40 consecutive patients with diuretic refractory ascites comparing our standard therapy of ascites recirculation (Rhodiascit apparatus) with the newly proposed method of daily paracentesis (3-4 litre) and intravenous albumin infusion. A mean of five (range 2-13) paracenteses removed 13.3 (2.0-36.0) l of ascites. 12 (5-32) h of recirculation produced 6.0 (2.0-12.0) l of waste. A significant diuresis occurred in 14 recirculation patients compared to four treated by paracentesis. No significant changes in electrolyte levels or renal function occurred. Complications were commoner with paracentesis (12) than with recirculation (5). Following recirculation, 18 patients were discharged after 7 (2-21) days; significantly (p less than 0.04) shorter than after paracentesis (11 (4-34) days, 16 discharges). Ascites reaccumulation and survival were identical in both groups. Fewer complications, shorter hospital stay and lower consumables costs (recirculation 240 pounds, paracentesis 400 pounds) make ascites recirculation an attractive therapeutic option to daily paracentesis and intravenous albumin in diuretic refractory ascites.

Adult↗
PubMed2006

Octreotide in the outpatient therapy of cirrhotic chylous ascites: a case report.

Chylous ascites is a rare complication of liver cirrhosis associated with a poor short-term prognosis. We report the case of an 80-year-old male cirrhotic patient with refractory chylous ascites associated with portal hypertension. He was treated with total parenteral nutrition but chylous ascites relapsed at suspension. Patient was put on long-term subcutaneous octreotide (100 microg t.i.d.) as an outpatient. The treatment was well tolerated and led to clinical improvement, markedly reducing the need of total paracentesis and the amount of ascites. Octreotide was stopped after 6 months, and massive ascites did not relapse. After 1 year the patient was alive, with no need of paracentesis. Octreotide therapy should be considered in patients with cirrhosis and chylous ascites to simplify the outpatient management of the disease.

Aged, 80 and over↗
PubMed2026

Ascites Bactericidal Capacity in Patients With Decompensated Cirrhosis.

BACKGROUND & AIMS: Patients with decompensated cirrhosis are at high risk of developing bacterial infections. The most common infection is spontaneous bacterial peritonitis in ascites fluid, caused by gut bacterial translocation and facilitated by cirrhosis associated immune dysfunction. Common causative agents of spontaneous bacterial peritonitis are thought to represent pathobionts that increase in abundance in the gut with cirrhosis severity, rather than opportunistic commensals. Despite this there have been few studies describing the characteristics of spontaneous bacterial peritonitis pathogens and immune responses to them. METHODS: We investigated the bactericidal capacity of cell-free ascites fluid and ascites macrophages. RESULTS: Nonpathogenic Escherichia coli K12 was rapidly killed in cell-free ascites fluid, whereas extraintestinal pathogenic E coli and Klebsiella pneumoniae strains, representative of the most common causes of spontaneous bacterial peritonitis, were resistant. A transposon-based genome-wide screen identified a requirement for genes involved in O-antigen biosynthesis for survival of both organisms in cell-free ascites fluid, including the transcription factor RfaH, which controls expression of surface polysaccharides. Although extraintestinal pathogenic E coli were resistant to fluid-mediated killing, ascites macrophages, especially VSIG4Hi cells, phagocytosed and killed extraintestinal pathogenic E coli and nonpathogenic E coli K-12 with similar efficacy. Mice with toxin-induced cirrhosis had higher bacterial burdens in the liver compared with control mice when infected with extraintestinal pathogenic E coli, but rapidly cleared an rfaH mutant attenuated for capsule and O-antigen biosynthesis. CONCLUSIONS: These data highlight the importance of understanding bacterial virulence profiles in addition to taxonomy in cirrhosis dysbiosis and identify critical roles for capsule and O-antigen in host evasion by spontaneous bacterial peritonitis-associated pathogens. Targeting bacterial virulence factors and/or host macrophage functions may reduce the risk of spontaneous bacterial peritonitis in cirrhosis.

Animals↗
PubMed1997

Increased angiotensin II in ascites during severe ovarian hyperstimulation syndrome: role of early pregnancy and ovarian gonadotropin stimulation.

OBJECTIVE: To investigate the implications of the ovarian renin-angiotensin system (RAS) in the pathophysiology of the ovarian hyperstimulation syndrome (OHSS) in relation to gonadotropin stimulation and early pregnancy. DESIGN: A controlled clinical study comparing blood and simultaneously sampled peritoneal fluid (PF) from patients with severe OHSS and from controls without OHSS. SETTING: University Hospitals. PATIENT(S): Eleven patients with severe OHSS, 8 patients with ascites of other origin, 9 patients with a first-trimester pregnancy, and 15 patients stimulated with gonadotropins for IVF. MAIN OUTCOME MEASURE(S): Angiotensin II immunoreactivity was measured in blood and PF and analyzed by high-performance liquid chromatography (HPLC) in ascites from OHSS. RESULT(S): Angiotensin II immunoreactivity (pg/mL; mean +/- SE) was highest in the ascites from pregnant OHSS (1,669 +/- 418), reaching levels 5 times higher than in the plasma (331 +/- 61) and 100 times higher than in control ascites (17 +/- 6.7). Angiotensin II immunoreactivity was elevated in the PF during early pregnancy (211 +/- 68) and after gonadotropin stimulation (244 +/- 41) and was higher than in the plasma in both groups. Analysis by HPLC showed that the majority of Ang II immunoreactivity in the ascites of OHSS was because of true Ang II. CONCLUSION(S): Severe forms of OHSS, especially those associated with pregnancy, are consistently characterized by huge concentrations of Ang II immunoreactivity in the ascites, proved to be true Ang II by HPLC analysis. This may be due to the synergistic effects of exogenous and endogenous hCG on the ovarian RAS.

Adult↗
PubMed1998

Increased ascitic level of hyaluronan in liver cirrhosis.

Hyaluronan (HA) is a polysaccharide that forms a critical component of extracellular matrixes. It is present in high concentrations in tissues undergoing remodeling and morphogenesis. Serum HA is elevated in patients with chronic liver disease, and this has been considered to be caused by impaired degradation by the liver endothelial cells. We studied the level of HA in the ascitic fluid and plasma from 27 patients with cirrhotic ascites. These values were compared with peritoneal dialysate effluent (PDE) and plasma from 33 patients with uremia who were undergoing continuous ambulatory peritoneal dialysis (CAPD). The median HA levels in ascitic fluid and plasma from our 26 patients with cirrhosis were significantly higher than corresponding PDE and plasma values from the 33 CAPD patients (p < 0.0001). The median peritoneal/plasma ratios of creatinine, albumin, and immunoglobulin G in either cirrhotic or CAPD patients were less than unity. In contrast, the median peritoneal/plasma ratios of HA in both groups of patients exceeded one with a higher peritoneal/plasma ratio of HA in patients with cirrhosis (p = 0.0035). A significant correlation was observed between the ascitic level of HA and interleukin-1beta, interleukin-6, or transforming growth factor-beta. Our in vitro cell culture studies revealed that HA is synthesized by both mesothelial cells and macrophages. We observed an additive effect in the synthesis of HA by mesothelial cells when the macrophage-conditioned medium was added to the RPMI culture medium. We conclude that a high level of HA is found in ascites from patients with cirrhosis. Our results strongly suggest that simultaneous increased synthesis of HA by the peritoneal cells and a reduction of degradation by liver endothelial cells occur in these patients with cirrhosis with ascites. This event of increased HA synthesis may be contributory to remodeling and regeneration of the peritoneal lining.

Adult↗
PubMed1997

Reinfusion of concentrated ascitic fluid versus total paracentesis. A randomized prospective trial.

We compared the efficacy and safety of apheresis and reinfusion of concentrated ascites (ARCA) versus total paracentesis plus intravenous albumin (PARA) in a prospective trial on cirrhotic patients with tense ascites. Twenty-four patients were randomized to either ARCA (N = 12) or PARA (N = 12), and followed for two years. Sex, age, Child's class, and renal and liver function were similar in the two groups. The times the procedures were 2.7 +/- 1.0 (ARCA) vs 2.2 +/- 1.1 (PARA) hr, with removal of 8.8 +/- 3.5 (ARCA) and 6.9 +/- 3.4 (PARA) liters of ascites and intravenous infusion of 59.8 +/- 35.2 (ARCA) and 42.5 +/- 20.5 (PARA) g of albumin. Both procedures were safe. Biochemical signs of coagulative disturbances having no clinical relevance were observed after ARCA, with an increase in prothrombin time (P = 0.005) and serum FSP (P = 0.02). No significant changes in renal function, serum albumin, or plasma and urinary electrocytes were shown. Plasma renin activity increased after PARA (P = 0.02) and plasma atrial natriuretic factor increased after ARCA (P = 0.008), although no differences were observed in diuresis in the immediate follow-up. During the long-term follow-up, patient survival and recurrence of tense ascites were the same in both groups. We conclude that apheresis and reinfusion of concentrated ascites are as safe and effective as total paracentesis with albumin infusion for the treatment of tense ascites in cirrhotic patients.

Adult↗
PubMed1985

Myelomatous ascites.

Ascites is an unusual feature of multiple myeloma. We report a case of ascites occurring early in the course of a patient with myeloma in whom there was no evidence of intra-abdominal plasmacytoma, and the skeleton was relatively spared. The serum contained predominantly polymeric IgA, a feature not investigated in previous cases. We reviewed the relevant literature and will discuss the suggestion that human myelomas presenting with the triad of ascites, relative or absolute sparing of the skeleton, and an IgA paraprotein bear an analogy to mouse myelomas induced by intraperitoneal instillation of irritants. The relevance of polymeric IgA is discussed with respect to tissue origin of the paraprotein. Seventeen cases were identified consistent with a definition of "myelomatous ascites" (malignant myeloma in which plasma cells and/or monoclonal immunoglobulin can be demonstrated in ascitic fluid). IgA immunoglobulin class was present at three times the incidence seen in myelomas in general (five of seven cases were specified). In twelve patients there was no identifiable intra-abdominal plasmacytoma although liver infiltration was common. Amyloidosis was reported in only one case, and no cases of uncomplicated plasma cell leukemia were noted. Ascites was a presenting feature in five cases. In each of these five there was absolute or relative sparing of the skeleton, four had no evidence of plasmacytoma, and the paraprotein was IgA in three, IgG in one, and unreported in one. In no case was there a known history of chronic intra-abdominal irritation.

Aged↗
PubMed2004

Diagnosis of malignant ascites in prostate cancer by measurement of prostate specific antigen.

We were confronted with a case of ascites in a man with known cirrhosis and advanced prostate cancer. Initial studies of ascitic fluid suggested cirrhosis as the cause of ascites. However, a prostate-specific antigen (PSA) study of ascitic fluid strongly suggested that the ascites was caused by prostate cancer. Subsequent cytologic studies confirmed malignant ascites. We suggest that measurement of PSA may be a valuable adjunctive study for the diagnosis of malignant effusions in prostate cancer.

Ascites↗
PubMedDate not supplied

Prevention of the febrile reaction occurring on reinfusion of cell-free and concentrated autogenous ascites.

The febrile reaction that occurs on reinfusion of ascites was studied. Intravenous reinfusion of ascites was performed 213 times in 63 cases of ascites, which were refractory to treatment with various drugs including diuretics. In order to prevent fever on reinfusion of ascites, a screen filter and a depth filter were used; the results were more favorable with the screen filter. Fibrin was considered to be one of the substances removable by the screen filter. HPLC analysis of the filtered and concentrated ascites, after passage through the screen filter, revealed a fraction corresponding to albumin. Intravenous injection of this fraction into rabbits caused fever. Although the screen filter cannot completely prevent fever on reinfusion of ascites, it appears useful to prevent fever in some patients.

Adult↗
PubMed1982

Role of protein content in CSF ascites following ventriculoperitoneal shunting. Case report.

The case is reported of an 11-year-old girl with a recurrent craniopharyngioma who developed massive ascites following a ventriculoperitoneal (VP) shunt procedure for hydrocephalus, associated with an elevated cerebrospinal fluid (CSF) protein level. The ascites resolved after removal of the shunt. The CSF protein returned to normal levels following excision of the recurrent craniopharyngioma, and ascites did not recur after a second VP shunt was inserted for recurrent hydrocephalus. In this case, elevated CSF protein is believed to have been responsible for ascites developing after VP shunting. There was no recurrence of ascites after the peritoneal cavity was again used for shunting, at which time the protein had returned to normal values. Twelve previous cases of ascites complicating VP shunting are reviewed and the etiology of the condition is discussed.

Ascites↗
PubMed1999

Spontaneous bacterial peritonitis in liver cirrhosis with ascites.

OBJECTIVE: The study was designed to elucidate the correlation of spontaneous bacterial peritonitis (SBP) with aetiology of liver cirrhosis, overall mortality, ascitic fluid and systemic microbial infections. METHODS: Sixty three patients with cirrhosis of the liver were included in this study. These patients were diagnosed on the basis of clinical evaluation, biochemical investigation, ultrasonography, ascitic fluid examination for protein, cells, pH, and bacterial culture. RESULTS: SBP developed in 22 (34.92%) patients of cirrhosis. Culture positive SBP was present in 18 (81.81%) and culture negative neutrocytic ascitis (CNNA) in 4 (18.18%). In the culture positive group, 14 (77.7%) patients had monomicrobial bacterascites (MNB), the commonest organism being coagulase positive Staphylococcus aureus eight (44.44%) followed by E. coli (22.22%). Only 4 (22.22%) had infection by more than one organism. Direct bed side inoculation of ascitic fluid into blood culture bottle was a better method for bacterial yield than the conventional method of ascitic fluid culture (81.8% vs. 18.2%). Only 22.8% patients with SBP had ascitic fluid protein less than 1 gm%, ascitic fluid pH < 7.3 and polymorphonuclear cell count > 250/cmm. CONCLUSION: Spontaneous bacterial peritonitis is common complication in Child Pugh class C cirrhosis. Alcoholic cirrhosis with SBP carries high mortality than their non-alcoholic group. The most common organisms isolated were coagulase positive Staphylococcus aureus followed by E. coli.

Ascites↗