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 1,405 records · Page 78Linked to original sources
PubMed1982

Hemorrhagic ascites: an unusual presentation of primary splenic lymphoma.

Hemorrhagic ascites is usually associated with a poor prognosis. A patient with hemorrhagic ascites having a potentially curable cause, primary splenic lymphoma (histiocytic type), is reported. It is believed that this is a new cause of hemorrhagic ascites that has not been previously described. The causes and pathogenesis of hemorrhagic ascites are reviewed. Computed tomography scan was helpful in suggesting the diagnosis and should be performed early in the evaluation of hemorrhagic ascites.

Ascites↗
PubMed1982

[Indications for lymphovenous anastomosis for ascites in cirrhosis of the liver].

The analysis of outcomes after the lymphovenous anastomosis on the neck of 52 patients with ascites due to cirrhosis of the liver are presented. In 16 cases ascites was arrested, in 15 patients there was a considerable elimination of ascites. In 14 cases the lympho-venous anastomosis resulted in stabilization of the ascitic syndrome, in 7 patients operation proved to be ineffective. In the nearest postoperative period 3 patients died. Two patients died of hemorrhage from the varicose-dilated veins of the esophagus an stomach, and one patients died of acute hepatic insufficiency. In the postoperative period and improvement of the functional state of the liver was noted. The authors propose to divide ascites into three stages which allowed to prognose results of the operation in the postoperative period and make the indications more definite.

Ascites↗
PubMed1982

Peritoneovenous shunting for intractable ascites.

Ten patients with intractable ascites were treated with the LeVeen peritoneovenous shunt. Of these, three died perioperatively. Three patients with malignant ascites died within 2-3 months, but with good shunt function. In four patients, the shunt became occluded, after 2 weeks to 8 months. Percutaneous puncture of the shunt and injection of radiopaque dye revealed the occlusion t be due to thrombosis of the venous limb of the shunt. In one patient, superior vena cava thrombosis occurred. Another ten patients were treated with the Denver peritoneovenous shunt. One patient died perioperatively; four patients with malignant ascites and one with cirrhosis died after 11 days-3 months, but with good shunt function. One patient with cirrhosis is alive after 5 months, with good function. In three patients the shunt became occluded after 5 days-1 month but two of these could be cleared with the fluschchamber of the Denver shunt. It seems that the Denver shunt functions better than the LeVeen shunt, and that the primary indication for peritoneovenous shunting is malignant ascites. Here palliation is excellent. No patient developed clinical signs of disseminated intravascular coagulation following ascites infusion and in six patients where coagulation variables were studed, there were no signs of a consumption coagulopathy.

Ascites↗
PubMed1981

[Endotoxins in the plasma and ascitic fluid of the cirrhotic patient. Their clinical significance].

The endotoxin presence was tested by Limulus Lysate Test (LLT) in plasma and ascites of 29 patients with cirrhosis, all having demonstrable portal hypertension and ascite. It was positive in plasma in 7 cases (24.1%) and in ascite in 12 cases (73.12%). All the cases with endotoxin in the plasma were positive in ascite too. 21 patients presented porto-sistemic encephalopathy from 1 to 4 grade, 1 case only had the clinical features of hepatorenal syndrome. The CHE and protrombin test values were significantly different in LLT positive patients in plasma and ascite respect to the values of negative ones.

Ascitic Fluid↗
PubMed1995

Ascites free-water dynamics in decompensated cirrhosis: effects of acute and chronic frusemide treatment.

OBJECTIVE: To evaluate the effects of acute (60 mg intravenous bolus) and protracted (75 mg per day orally for 1 week) frusemide administration on ascites volume, free-water peritoneal clearance (FWPC), intra-abdominal pressure (IAP) and body weight in 30 decompensated cirrhotic patients. METHODS: Individual ascites volume and FWPC were estimated by means of a previously validated methylene-blue dilution test. RESULTS: All the investigated parameters showed a significant reduction after the protracted diuretic treatment (ascites volume 9.0 +/- 1.0 to 4.9 +/- 0.61, P < 0.001; FWPC 99.8 +/- 6.7 to 76.2 +/- 6.6 ml/min, P < 0.001; IAP 17.0 +/- 1.5 to 11.3 +/- 0.8 cmH2O, P < 0.001; body weight 75.2 +/- 1.9 to 66.3 +/- 1.8 kg, P < 0.001). A significant FWPC reduction (89.5 +/- 14.6 to 68.8 +/- 12.1 ml/min, P < 0.02) was also observed after the acute frusemide administration in the absence of any appreciable modifications to ascites volumes and IAP. CONCLUSION: Frusemide treatment appears to be able to exert a direct significant effect on FWPC, which does not appear to be mediated by ascites volume or IAP modifications.

Abdomen↗
PubMed1994

[Prognostic significance of ascites in patients with liver cirrhosis].

The author evaluates the prognostic importance of ascites in 100 patients with cirrhosis of the liver. The patients were followed up on a log-term basis in a hepatology clinic and the diagnosis was confirmed morphologically. Ascites developed at a time when marked objective and laboratory signs of chronic liver disease were present. Ascites was diagnosed by physical examination and verified by ultrasonography. It was treated by contemporary procedures. Survival of cirrhotic patients with ascites was unfavorable--50% survived one year, 38% two years, 17% three years, 15% four years and only 9% five years. Ascites is thus still a very adverse prognostic indicator for patients with cirrhosis.

Ascites↗
PubMed1994

Nephrogenic ascites. Case report and review of the literature.

Nephrogenic ascites is a clinical diagnosis defined as persistent ascites in an uremic patient without evidence for a causative (specific) underlying disease. The incidence is not known. Contributing mechanisms may include peritoneal membrane changes, fluid overload, hyperparathyroidism, reduced lymphatic drainage, heart failure and hypoproteinemia. Rigid fluid control, intensive hemodialysis, high-protein diet, intravenous albumin infusion, intraperitoneal steroid injections and paracenteses as well as implantation of a peritoneatrial pump have all been found ineffective as treatment. Peritoneal dialysis has been shown to resolve ascites, however, the only effective treatment is so far renal transplantation. The development of nephrogenic ascites is associated with a poor prognosis. Thus, one year after the development of nephrogenic ascites 1/3 had died.

Adult↗
PubMed1994

[Multiple myeloma with massive ascites fluid--immunophenotypic analysis of myeloma cell and its IL-6-dependent growth].

A 75-year-old female was diagnosed as having multiple myeloma (IgG.lambda type. Stage IIA) with plasmacytoma of the head and back in October, 1989. She obtained partial remission by MCNU and MP therapy, but relapsed with massive ascites in January, 1991. VAD therapy was not effective and she died of multiple organ failure on February 23. Her ascites contained a large number of myeloma cells, and the phenotypic analysis and the response to interleukin-6 (IL-6) of these myeloma cells were examined. The myeloma cells were positive for CD33, CD45, CD45RA, CD63, CD71, plasma cell associated antigens such as CD38, PCA-1, BL3, and various kinds of adhesion molecules: CD11a/CD18 (LFA-1), CD29 (VLA-beta 1), CD44 (H-CAM), CD49d (VLA-4), CD54 (ICAM-1), CD56 (N-CAM), CD58 (LFA-3). IL-6 level in the ascites was increased at 91.0pg/ml. The myeloma cells showed an IL-6 dependent growth, which was inhibited by anti-IL-6 antibody (Ab) and anti-IL-6 receptor Ab in vitro. Myeloma cells appearing in ascites have rarely been reported. Our case suggested that IL-6 was a potent growth factor of myeloma cells through an autocrine mechanism in the ascites, and resulted in an aggressive myeloma.

Aged↗
PubMed1994

Ascites and secondary bacterial peritonitis associated with small bowel obstruction.

Wide albumin gradient (transudative) ascites is usually due to liver disease but may also result from many other disorders, including heart failure, hepatic infiltration by tumor, hepatic vein thrombosis, and veno-occlusive disease. It has not been linked with small bowel obstruction. Narrow albumin gradient (exudative) ascites, usually due to peritoneal carcinoma or inflammation, has been noted in cases of necrotic or perforated bowel, but simple small bowel obstruction has not previously been appreciated as a possible cause for ascites. We report a patient who developed wide albumin gradient ascites and secondary bacterial peritonitis in association with small bowel obstruction. The small bowel obstruction, ascites, and peritonitis resolved with lysis of a single abdominal adhesion.

Aged↗
PubMed1994

Mitoxantrone in the treatment of recurrent ascites of pretreated ovarian carcinoma.

In this study we treated 19 patients with relapsed ovarian cancer with malignant peritoneal effusion. All patients were previously treated with cisplatin-containing regimens. Intraperitoneal mitoxantrone was administered at a dosage of 20-30 mg/mq repeated every 28 days if ascites was still present. No patient was treated with systemic chemotherapy during the study. In 15 of 19 patients progressive ascites reduction was obtained. Moreover, in 4 of 15 responsive patients, a progressive reduction of the quantity of ascites was observed even though the abdominal masses demonstrated an increase in volume. Serum concentrations of Mitoxantrone (MXN) were determined, in ten patients, by high performance liquid chromatography with spectrophotometric detection, and low serum levels (1-30 ng/ml) with a maximum at the first or second hour were revealed. In conclusion, in patients with ovarian carcinoma and recurrent neoplastic ascites, palliative treatment with mitoxantrone was effective and well tolerated. The reduction of ascites and frequency of paracentesis represents a marked advantage for these patients and improves their quality of life.

Adult↗
PubMed1993

[Ectopic ascites secondary to the implantation of a LeVeen shunt].

Insertion of a peritoneovenous shunt is an effective method of treatment of refractory ascites although not free of complications. The incidence of them varies between 20-50%, being obstruction, infection and disseminated intravascular coagulation the more frequent. We report a case of a patient that presented with ectopic ascites in cellular subcutaneous tissue one year after the placement of the shunt. This complication was due to an increase of ascites. Treated with paracentesis the ascites decreased and the ectopic ascites resolved.

Abdomen↗
PubMed1995

Prognosis assessment of cirrhotic patients with refractory ascites treated with a peritoneovenous shunt.

OBJECTIVE: The role of peritoneovenous shunt in the management of refractory ascites has not been clearly established. The aim of this study was to determine readily accessible predictive survival factors in cirrhotic patients with refractory ascites treated with a peritoneovenous shunt. METHODS: We studied a cohort of 100 cirrhotic patients with refractory ascites who underwent peritoneovenous-shunt placement in a university-based reference hospital. RESULTS: The estimated median survival of patients after shunt placement was 11 months (95% CI, 7-14 months). Multivariate analysis based on the proportional hazards model disclosed four independent variables associated with poor survival: high Pugh score, nonalcoholic etiology, low ascitic fluid protein concentration, and history of spontaneous bacterial peritonitis. CONCLUSIONS: Mortality of cirrhotic patients treated with a peritoneovenous shunt can be determined by a prognostic index using four easily available variables. Such a prognostic index, once prospectively validated, could be used as an adjunct in planning treatment of cirrhotic patients with refractory ascites.

Ascites↗
PubMed1995

Spontaneous intrauterine remission of fetal ascites in one identical twin. Report of a case with ultrasound evaluation.

BACKGROUND: Fetal ascites is usually a precursor of, or one of the findings in, hydrops fetalis. The spontaneous intrauterine remission of fetal ascites, especially in twin pregnancy, is extremely low. CASE: A woman had sonographically documented fetal ascites in one identical twin. The workup for immunologic or nonimmunologic causes was negative except for the absence of end diastolic flow in the umbilical artery, demonstrated by Doppler ultrasonography in the affected fetus. Subsequent sonographic examinations demonstrated disappearance of the ascites as resistance of the umbilical artery progressively improved. CONCLUSION: In evaluating the hemodynamic changes in this condition, Doppler ultrasonography can elucidate the pathophysiology of fetal ascites formation in a monochorionic twin and also provide information for guiding management.

Adult↗
PubMed1995

High levels of proteolytic enzymes in the ascitic fluid and plasma of rats bearing the Yoshida AH-130 hepatoma.

Plasma and ascitic fluid of rats bearing the Yoshida ascites hepatoma AH-130 were shown to contain high levels of proteolytic enzymes belonging to different classes active at neutral and acidic pH. Relative to those measured in control rat plasma, in tumor-bearing animals, the activity levels of lysosomal cathepsins B and L, in their latent, acidic-activatable form, were approximately 5-fold higher in plasma and 9-fold higher in ascitic fluid, and cathepsin D activity was about 5-fold higher in both plasma and ascitic fluid. Plasma and ascitic fluid of tumor-bearing rats also contained novel neutral and acidic gelatinolytic activities. The latter, as revealed by zymographic analysis conducted at pH 6.0, in the presence of dithiothreitol and in the absence of divalent metal ions, was sensitive to iodoacetamide inhibition but not to EDTA, showed a molecular mass of approximately 90 kD on SDS-PAGE, and was lost upon limited proteolysis with pepsin. Therefore, this enzyme is not identifiable as cathepsin B or L or their related latent forms and may represent a novel, so far undescribed, gelatinase. Its presence exclusively in the body fluids of AH-130-bearing rats suggests its possible use as a tumor marker.

Animals↗
PubMedDate not supplied

Surgical treatment of pancreatic ascites and pancreatic pleural effusions.

BACKGROUND/AIMS: Massive ascites and pleural effusions are uncommon but well-documented complications of chronic pancreatitis. The present study reviews the results of surgical management of pancreatic ascites and pleural effusions of pancreatic origin. PATIENTS AND MATERIALS: From forty-nine patients with chronic pancreatitis presenting with ascites and/or pleural effusion of pancreatic origin, 31 were surgically treated. RESULTS: Nineteen had ascites only, ten pleural effusions and two presented with both conditions. Diagnosis of the internal pancreatic fistula was based on the findings of high amylase levels and elevated albumin content of the peritoneal and pleural exudates. Failure of medical therapy was the indication of surgical treatment in all patients. Thirteen were submitted to internal pancreatic drainage, 17 to external drainage and one to distal pancreatic resection. Eight of 17 externally drained patients were reoperated for intraperitoneal abscesses (2), infected pseudocyst (1), pain recurrence (3) and pancreatic fistula (2); whereas reoperation occurred in only one of the 13 patients submitted to internal drainage (p < 0.05). CONCLUSIONS: Internal pancreatic drainage was the ideal surgical treatment for patients with pancreatic ascites and/or pleural effusion that did not respond to medical treatment. When this was not feasible external drainage was successfully used as an alternative to pancreatic resection.

Adult↗
PubMed1996

[Massive ascites as an initial sign, plasmacytoma of the cervical supine, and hyperammonemic consciousness disturbance in a patient with biclonal type multiple myeloma].

A 69-year-old male presented with fever, ascites and leg edema in February, 1994. He had a pathological fracture of cervical supine in October. Pathological findings at operation showed plasmacytoma. Bone marrow aspiration showed 16.2% myeloma cells. So he was diagnosed as multiple myeloma presenting biclonal gammopathy of IgA-L and IgD-K. Ascites was massive and drainage of 2 to 4 liter per week was required. Ascites was supposed to be related to multiple myeloma, because the IL-6 level in the ascites was increased (2,440 pg/ml), although repeated cytologic studies were negative. After the operation, he developed hyperammonemic drowsiness. It was also suggested that hyperammonemia was associated with multiple myeloma. In addition to radiation therapy for the cervical lesion, MP therapy, Interferon-alpha, VAD therapy and intraperitoneal cyclophosphamide infusion were administered. But no improvement of ascites or hyperammonemia were noticed. Here we described a case of multiple myeloma with very notable clinical features.

Aged↗
PubMed1996

Discrepancy between solute transport rate and drain volume in CAPD patients with ascites.

The ascites in the chronic renal failure patient is often difficult to treat and becomes intractable. Continuous ambulatory peritoneal dialysis (CAPD), as a maintenance therapy, is effective in the removal of ascites and may become a good alternative in dialysis therapy. The aim of this study was to evaluate the peritoneal membrane transport characteristics and ultrafiltration rate in CAPD patients who had preexisting ascites. Seven CAPD patients (6 male, 1 female; mean age 43 +/- 11 years) were included. The causes of ascites were liver cirrhosis (n = 4), hemodialysis-associated process (n = 2), and heart failure (n = 1). A peritoneal equilibration test (PET) using 2.5% dialysate was performed by the standard method at ten days after starting CAPD. The solute transport rate [dialysate glucose ratio (D/D6) and dialysate-to-plasma creatinine concentration ratio] showed high (n = 5) or high average (n = 2) transport. In 5 patients with high transport, PET showed a discrepancy between solute transport rate and drain volume. In spite of the high transport rate, the drain volume was greater than expected and corresponded to the area of low average or high average solute transport rate. Considering adequate solute clearance and good ultrafiltration, CAPD is an effective treatment in end-stage renal disease patients with intractable ascites.

Adult↗
PubMed1996

[Value of laparoscopy in ascites of undetermined origin].

OBJECTIVE: To assess the diagnostic accuracy of laparoscopy in the study of patients with ascites of unknown cause, and the frequency of laparoscopy use for that indication after the advent of ultrasonography and computed tomography. DESIGN: A retrospective study of 4.536 laparoscopies performed in 16 years, in two periods of 8 years, and the correlation with the pathologic diagnosis. PATIENTS: 137 patients in whom laparoscopy was indicated for the study of ascites of unknown cause. RESULTS: 63.5% of laparoscopies were performed over the first 8-year period, and 36.5% in the second (p = 0.0001), and for the study of ascites 2.6 and 3.8% respectively. Laparoscopy and biopsy were diagnostic in 98.5% of cases; 51% carcinomatosis, 17.5% liver cirrhosis, 11.7% hepatic neoplasm and others. Two of five cases of peritoneal tuberculosis were considered carcinomatosis at laparoscopy. There were no serious complications. CONCLUSIONS: The advent of new imaging method has reduced the use of laparoscopy, although it is still employed frequently for the study of ascites. Laparoscopy with biopsy when necessary has an excellent effectiveness and accuracy for the diagnosis of ascites of unknown cause.

Ascites↗