• Title/Summary/Keyword: paracentesis

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Puncture needle with a hard plastic sheath and plastic wings minimizes repuncture attempts in ultrasound-guided paracentesis: a retrospective case-control study

  • Son, Il Wan;Kim, Suk;Hong, Seung Baek;Lee, Nam Kyung;Jeong, Mi Ri;Han, Sung Yong;Woo, Hyun Young
    • Journal of Yeungnam Medical Science
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    • v.39 no.1
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    • pp.18-23
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    • 2022
  • Background: This study was performed to evaluate periprocedural factors, complications, and repuncture rate of the newly developed puncture needle and compare it with the routinely used puncture needle for ultrasound (US)-guided paracentesis. Methods: We retrospectively identified 137 patients who underwent US-guided paracentesis between July 2018 and March 2019. Among them, 82 patients underwent US-guided paracentesis with a newly developed puncture needle. The other 55 patients underwent US-guided paracentesis with a routinely used puncture needle. The periprocedural factors, complications, and repuncture rate were compared between the two groups using the Mann-Whitney U test and Fisher exact test. The repuncture-associated factors were assessed using logistic regression analysis. Results: There were no major or minor complications in either group. The rate of repuncture was significantly lower in the group using the newly developed puncture needle compared with the group using the routinely used puncture needle (p=0.01). The duration of the procedure was significantly shorter with the newly developed puncture needle compared with the routinely used puncture needle (p=0.01). In univariate analysis, the thickness of the abdominal wall (p=0.04) and the use of the newly developed puncture needle (p=0.01) were significantly associated with the rate of repuncture. In multivariate analysis, only the use of the newly developed puncture needle was significantly associated with the rate of repuncture. Conclusion: Using this novel puncture needle with a hard plastic sheath and plastic wings, the rate of repuncture and the duration of the procedure were decreased without complications of US-guided paracentesis.

Diagnosis of Cholangiocellular Carcinoma in a Dog (개에 발생한 간내 담관상피암의 진단예)

  • 이현범;장인호;장종식
    • Journal of Veterinary Clinics
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    • v.14 no.1
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    • pp.123-125
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    • 1997
  • A 5-years-old female pointer dog was submittedto the hospital with the disease history of gradual distension of abdomen and emaciation for two months. An applesized hard mass was palpated on the right costal arch on physical examination. On blood chemical analysis, the marked elevation of SALT and decrease in serum albumin were detected. On paracentesis, a large volume of blood tinged fluid was detected. The peritoneal fluid contained tumor cells and the numerous blood cells. At autopsy the tumor mass located in the left medial lobe of liver was whitish and firm, and was consisted of many cysts. Histologically the tumor was identified as typical cholangiocellular carcinoma. Metastatic lesions of the tumor were detected in the lung, stomach, spleen, diaphragm, and lymph glands. This observation indicates that the cytological examination of the abdominal fluid have a diagnostic significance in the clinical examination of patients with abdominal tumors.

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Clinical Analysis of Chylous Ascites after Surgery for Gastric Cancer (위암수술 후 발생한 유미성 복수증의 임상적 고찰)

  • Hong Jeong Hun;Min Byung Wook;Lee Gyung Bum;Mok Young Jae
    • Journal of Gastric Cancer
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    • v.2 no.1
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    • pp.20-25
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    • 2002
  • Purpose: Chylous ascites is an accumulation of lymphatic fluid within the peritoneal cavity due to trauma or to an obstruction on the lymphatic system. Postoperative chylous ascites is a rare complication of abdominal surgery. It is frequently reported after retroperitoneal dissections and results in high morbidity and mortality. However, there have been few report of such a complication following a radical gastrectomy. Therefore, we review the clinical analysis and treatment of chylous ascites based on our experience. Materials and Methods: From July 1992 to June 2001, we treated 13 cases of chylous ascites after operations for gastric cancer. We reviewed medical charts of those patients retrospectively. Results: The incidence of chylous ascites after operations for gastric cancer was $0.83\%$ (13/1552). The mean time from ingestion of a meal after the operation to the development of symptoms was 2 days (range: $1\∼6$ days). Conservative treatment by fasting, total parenteral nutrition (TPN), and repeated paracentesis was successful in all patients. The mean time from diagnosis to complete resolution was 25 days (range: $2\∼105$ days). Conclusion: Chylous ascites should be considered in any patient with a typical milky color of drainage who has recently undergone radical gastrectomy. Treatment with fasting, TPN, and repeated paracentesis usually is successful.

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The Management of Malignant Ascites in Terminal Cancer Patients (말기 암환자에서 악성 복수의 치료)

  • Kim, Sun-Hyun;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.11 no.3
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    • pp.131-135
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    • 2008
  • The management of malignant ascites can be problematic for physicians and patients. The mass effect of ascites can cause symptoms of painful abdominal distention, nausea, vomiting, and bowel obstruction. Also patients often complain of shortness of breath and lower extremity edema. These symptoms not only are distressing, but also adversely affect quality of life in terminal cancer patients. We will introduce you how to treat ascites based on our cases.

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Chylous Ascites After Aorto-Bifemoral bypass Graft (대동맥-양측대퇴동맥 우회술 후 발생한 유미 복수)

  • Jo, Gyu-Cheol;Kim, Dong-Won;Yu, Se-Yeong
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.798-800
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    • 1994
  • Chyloascities is an extravasation of milky chyle into the peritoneal cavity due to tumor , inflammation or rarely postoperative lymphatic trauma.It is an unusual complication that can lead to significant immunologic and nutritional consequences.We experienced one case of chyloascites after aorto-bifemoral bypass graft in a patient with aorto-iliac occlusive disease.The patient was a 62-year-old male, who suffered from severe progressive claudication for 5 months. A 16$\times$ 8mm gelsealed Dacron-Y shaped graft was used in arterial reconstruction. A bloody-milky fluid was drained through the operative wound from 3days after operation and evaluated biochemically.Diagnosis of chyloascites was made with repeated paracentesis and examination of the fluid.After Total parenteral nutrition[T.P.N] for 3 weeks from 6days after operation, chyloascites was controlled sufficiently and maintained a good graft-patency in abdominal sonogram.

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Hemangiosarcoma in a German Shepherd Dog (German Shepherd견의 혈관육종례)

  • 윤정희;권오경;성재기
    • Journal of Veterinary Clinics
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    • v.13 no.1
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    • pp.87-92
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    • 1996
  • A hemangiosarcoma in a 30 kg, 6-year-old German Shepherd dog showing signs of abdominal distension, anorexia and depression was diagnosed with clinicopathologic examination, abdominal radiographs and ultrasonographic assessmint. In abdominal radiographs, overall abdominal distension was seen. Stomach and some parts of small intestines were deviated caudo-ventrally by enlarged liver. The splenomegaly was also identified and descending colon was dislocated laterally by splenic mass. In ultrasonographic findings, abdominal fluid was identified. Hepatomegaly was seen and it was consisted of multiple, anechoic cysts. The spleen was enlarged and a large round mass with mixed echo pattern at the mid to tail portion of spleen was identified. Grossly, at necropsy, multi-sized cysts in which contained blood and fibrpus materials and some blood were seen in the cross section and it showed hard consistency. Also, lots of small red tumor nodules were dispersed on the serosal surface of the bladder, omentum, mesentery, diaphragm and peritoneum. In abdominal paracentesis, fluid having almost the same properties as circulating blood was identified. The hemoperitoneum was thought to be resulted from the bleeding into peritoneum owing to the rupture of cystic lesions located on the superficial liver area.

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Surgical Treatment of Cervical Salivary Mucocele in a Pit Bull Terrier (피쁠견에서 경추타액점액류의 외과적치료)

  • 정순욱;정월순;박수현
    • Journal of Veterinary Clinics
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    • v.16 no.1
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    • pp.210-213
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    • 1999
  • A 15 months old male pit bull terrier was shown submandibular swelling, which was extended from left submandibular area through mandibular symphysis to right submandibular area and toward around left neck. In history taking, recurrence of swelling was recorded after conservative surgical incision, drainage and dressing. Palpation revealed no pain and heating, partial flutuation and hardness. By paracentesis, it was showed blood-tinged tenacious exudate without bad-smelling. Left submandibular salivary gland was able to be movable freely and the size decreased to half of that of right submandibular salivary gland. It was diagnosed as cervical salivary mucocele. In operation, rostral portion of left sublingual salivary gland was observed to be damaged transversely, showed black color and leaked saliva. Submandibular gland and rostral portion of sublingual salivary gland were resected, after ligation of ducts of submandibular and sublingual salivary glands. At 15 days postoperation, serosanguineous exudate from operation wound was dramatically decreased and stable granulation tissue mass at this area was first palpated. At 39 days after operation, outline of left and right mandibular was appeared normal and skin tenderness of mandibular area was equal to that of the other body wall.

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A case of delayed hemorrhage of a subcapsular liver hematoma in a neonate (신생아에서 발생한 대량 피막하 간 혈종의 지연성 파열 1례)

  • Moon, Soo Kyoung;Lee, Tae Suk;Yoon, Hye Sun
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.89-92
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    • 2008
  • A subcapsular liver hematoma (SLH) is a relatively common lesion in fetuses and neonates. Although an SLH ruptures rarely, it may be life threatening. We report on a term neonate with a delayed rupture of an SLH that occurred on day 7 of life. The infant had been resuscitated with intubation, positive pressure ventilation, and chest compression at birth because of meconium-associated perinatal depression. The SLH was diagnosed by abdominal ultrasonography and paracentesis, and the ruptured SLH was treated operatively. After intensive medical and surgical management, the infant was discharged healthy on day 27 of life. A newborn infant presenting with the sudden onset of extreme shock and pallor associated with abdominal distension should undergo differential diagnosis for SLH and a clinical evaluation concurrent with fluid resuscitation and timely surgery.

Retinal Function Analysis and Histopathologic Assessment after Intravitreal Cidofovir Injection in Normal Beagle Dogs

  • Park, Sungwon;Kang, Seonmi;Park, Sangwan;Han, Jiseok;Kim, Yongbum;Seo, Kangmoon
    • Journal of Veterinary Clinics
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    • v.34 no.5
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    • pp.341-346
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    • 2017
  • This study was performed to evaluate the effects of an intravitreal injection of cidofovir in beagle dogs. Nine beagle dogs (18 eyes) were used and randomly assigned to the following three groups of various dosages: 100, 500 and $1000{\mu}g$. Aqueous paracentesis was followed by an intravitreal injection of cidofovir. Intraocular pressure (IOP) was measured twice a week and electroretinography (ERG) and ophthalmoscopic examination were performed every week during the study. At the end of the study, all eyes were enucleated for histopathologic evaluation after euthanasia. The IOPs in the 500 and $1000{\mu}g$ groups were statistically lower than baseline with no significant IOP changes in the $100{\mu}g$ group. Reduced amplitudes of ERG recordings were identified in the eyes injected with higher dose groups than the $100{\mu}g$ group. Histopathologic examination revealed that there were dose-related toxicities to the ciliary body and the retina. These results suggest that intravitreal cidofovir had dose-dependent IOP lowering effects associated with ciliary body destruction, but had the potential to cause retinal toxicity in beagle dogs.

Ovarian Hyperstimulation Syndrome with Minimal Ascites and Severe Hydrothorax Induced by Quintuplet Pregnancy (오태아 임신에 의해 유발된 경미한 복수와 중증 흉수의 난소과자극증후군)

  • Jung, Hee-Jung;Kim, Hoon;Kim, Young-Jin;Ku, Seung-Yup;Kim, Seok-Hyun;Choi, Young-Min;Kim, Jung-Gu;Moon, Shin-Young
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.2
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    • pp.137-142
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    • 2009
  • Ovarian hyperstimulation syndrome (OHSS) is one of the most common iatrogenic complications induced by assisted reproductive technology. Hydrothorax develops in about 10 percent of patients with severe OHSS and it is usually associated with marked ascites. On the other hand, severe hydrothorax without marked ascites is uncommon, and its pathogenesis remains unclear. We recently experienced a case of severe unilateral hydrothorax with minimal ascites induced by quintuplet pregnancy following intrauterine insemination with controlled ovarian hyperstimulation. Severe hydrothorax was resolved after only conservative and symptomatic management without invasive procedure such as thoracentesis or paracentesis. We report this case with brief review of literature.