• Title, Summary, Keyword: ascites

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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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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.

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.

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
    • Yeungnam University Journal of Medicine
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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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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.

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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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.

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.

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.