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Refractory ascites

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https://www.readbyqxmd.com/read/29755076/-constrictive-pericarditis-with-intractable-ascites-after-aortic-valve-replacement-report-of-a-case
#1
Rie Kageyama, Kyouhei Ueno, Masatoshi Sunada, Hirofumi Midorikawa, Megumu Kanno, Takashi Takano, Kouichi Satou
We report a 68-year-old man, who developed refractory ascites of unknown cause after aortic valve replacement. He was diagnosed with constrictive pericarditis because of "dip-and-plateau" waveform findings via cardiac catheterization and operated with cardiopulmonary bypass. Following waffle procedure, we incised pericardium for decompression, so that pericardial mobility and diastolic dysfunction was improved. Postoperative computed tomography (CT) image also showed decrease of ascites fluid. We concluded that pericardiotomy is an established surgical procedure and is excellent indication to constrictive pericarditis...
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29738325/automated-low-flow-ascites-pump-in-a-real-world-setting-complications-and-outcomes
#2
Philipp Solbach, Christoph Höner Zu Siederdissen, Freya Wellhöner, Nicolas Richter, Benjamin Heidrich, Henrike Lenzen, Port Kerstin, Katja Hueper, Michael P Manns, Heiner Wedemeyer, Elmar Jaeckel
BACKGROUND AND AIMS: The aim of this study was to investigate the Alfapump, an automated low-flow pump system for the treatment of refractory ascites (RA) as an alternative for repeated large-volume paracentesis in patients with contraindication for placement of a transjugular intrahepatic portosystemic shunt (TIPS) or liver transplantation. MATERIALS AND METHODS: In 21 consecutive patients with RA and contraindication for a placement of a TIPS, the Alfapump was implanted at Hannover Medical School between December 2012 and May 2016...
May 7, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29725793/nonselective-beta-blockers-do-not-affect-survival-in-cirrhotic-patients-with-ascites
#3
REVIEW
Antonio Facciorusso, Sunil Roy, Sarantis Livadas, Adwalia Fevrier-Paul, Clara Wekesa, Ismail Dogu Kilic, Amit Kumar Chaurasia, Mina Sadeq, Nicola Muscatiello
BACKGROUND: The role of nonselective beta-blockers in cirrhotic patients with ascites has been recently questioned; however, definitive evidence in this regard is still lacking. AIMS: To analyze published data on the influence of nonselective beta-blockers as compared to control group on survival of cirrhotic patients with ascites. METHODS: Computerized bibliographic search on the main databases was performed. Hazard ratios from Kaplan-Meier curves were extracted in order to perform an unbiased comparison of survival estimates...
May 3, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29668568/transjugular-intrahepatic-portosystemic-shunt-insertion-for-the-management-of-portal-hypertension-in-children
#4
Lauren Johansen, Patrick McKiernan, Khalid Sharif, Simon McGuirk
OBJECTIVES: To describe our 20-year experience with transjugular intrahepatic portosystemic shunt (TIPSS) procedures for children with resistant portal hypertension (PHTN). METHODS: Retrospective review of all children that had a TIPSS performed at Birmingham Children's Hospital from 1 January 1995 - 1 January 2015. RESULTS: 40 children underwent 42 attempted TIPSS for resistant PHTN with recurrent variceal bleeding (n = 35), refractory ascites (n = 4), and hypersplenism (n = 1)...
April 17, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29661430/access-to-liver-transplantation-in-different-abo-blood-groups-and-exceptions-points-in-a-model-for-end-stage-liver-disease-allocation-system-a-brazilian-single-center-study
#5
R B Martino, D R Waisberg, A P M Dias, V B S Inoue, R M Arantes, L B P Haddad, V Rocha-Santos, R S N Pinheiro, L S Nacif, L A C D'Albuquerque
BACKGROUND: In the Model for End-Stage Liver Disease (MELD) system, patients with "MELD exceptions" points may have unfair privilege in the competition for liver grafts. Furthermore, organ distribution following identical ABO blood types may also result in unjust organ allocation. The aim of this study was to investigate access to liver transplantation in a tertiary Brazilian center, regarding "MELD exceptions" situations and among ABO-blood groups. METHODS: A total of 465 adult patients on the liver waitlist from August 2015 to August 2016 were followed up until August 2017...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29650840/-a-case-of-effective-palliative-care-with-cart-for-refractory-ascites-associated-with-cancerous-peritonitis-of-gastric-cancer
#6
Junji Kawada, Masaya Nishino, Tomoki Hata, Takayuki Ogino, Hiromitsu Hoshino, Miho Okano, Kenichi Nagai, Yongkook Kim, Masaki Okuyama, Toshimasa Tsujinaka
Refractory ascites associated with cancerous peritonitis causes abdominal tension and reduced oral intake. Frequent ascites drainage can cause rapid worsening ofa patient's general condition. Cell-free and concentrated ascites reinfusion therapy (CART)for refractory ascites was first covered in 1981, and the general conditions ofpatients and their symptoms could be improved after undergoing CART. Herein, we report a case of effective palliative care with CART for refractory ascites associated with cancerous peritonitis...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29577037/chylous-ascites-a-review-of-pathogenesis-diagnosis-and-treatment
#7
REVIEW
Richa Bhardwaj, Haleh Vaziri, Arun Gautam, Enrique Ballesteros, David Karimeddini, George Y Wu
Chylous ascites (CA) is a rare form of ascites that results from the leakage of lipid-rich lymph into the peritoneal cavity. This usually occurs due to trauma and rupture of the lymphatics or increased peritoneal lymphatic pressure secondary to obstruction. The underlying etiologies for CA have been classified as traumatic, congenital, infectious, neoplastic, postoperative, cirrhotic or cardiogenic. Since malignancy and cirrhosis account for about two-thirds of all the cases of CA in Western countries, in this article we have attempted to reclassify CA based on portal and non-portal etiologies...
March 28, 2018: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/29564669/alterations-in-docosahexaenoic-acid-related-lipid-cascades-in-inflammatory-bowel-disease-model-mice
#8
Shin Nishiumi, Yoshihiro Izumi, Masaru Yoshida
BACKGROUND: Inflammatory bowel disease (IBD) is an intestinal disorder, involving chronic and relapsing inflammation of the digestive tract. Dysregulation of the immune system based on genetic, environmental, and other factors seems to be involved in the onset of IBD, but its exact pathogenesis remains unclear. Therefore, radical treatments for ulcerative colitis and Crohn's disease remain to be found, and IBD is considered to be a refractory disease. AIMS: The aim of this study is to obtain novel insights into IBD via metabolite profiling of interleukin (IL)-10 knockout mice (an IBD animal model that exhibits a dysregulated immune system)...
March 21, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29557942/development-and-validation-of-a-patient-reported-outcome-measurement-for-symptom-assessment-in-cirrhotic-ascites
#9
Myrte Neijenhuis, Tom J G Gevers, Thomas D Atwell, Tim J Gunneson, Amanda C Schimek, Wietske Kievit, Joost P H Drenth, Patrick S Kamath
OBJECTIVES: As current treatments of cirrhotic ascites are not associated with survival benefit, symptom relief is the major therapeutic end point. We developed a questionnaire (Ascites-Q; modified polycystic liver disease questionnaire) and assessed validity and responsiveness for symptom assessment in cirrhotic ascites. METHODS: Ascites-Q was compared with Functional Assessment of Chronic Illness Therapy-Ascites Index (FACIT-AI; developed for malignant ascites) and Japanese Ascites Symptom Inventory-7 (ASI-7) in cirrhotics undergoing large-volume paracentesis...
April 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29532591/un-precipitated-acute-kidney-injury-is-uncommon-among-stable-patients-with-cirrhosis-and-ascites
#10
Florence Wong, Peter Jepsen, Hugh Watson, Hendrik Vilstrup
BACKGROUND & AIMS: Acute episodes of renal dysfunction or acute kidney injury (AKI) in cirrhotic patients with ascites are mostly precipitated by an acute event. The prevalence of un-precipitated AKI in stable ascitic cirrhotic patients is unknown. The aims of this study were to determine (i) the prevalence of un-precipitated AKI in stable cirrhotics with ascites and (ii) any predictive factors for its development. METHODS: A total of 1115 stable cirrhotic patients with mild liver and renal dysfunction but varying degrees of ascites severity from 3 previous satavaptan vs placebo randomized controlled trials (Group A, ascites requiring diuretics but not paracentesis; Group B, ascites requiring frequent paracentesis; Group C, refractory ascites) were included...
March 13, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29524461/endolymphatic-interventions-for-the-treatment-of-chylothorax-and-chylous-ascites-in-neonates-technical-and-clinical-success-and-complications
#11
Rajiv N Srinivasa, Jeffrey Forris Beecham Chick, Joseph J Gemmete, Anthony N Hage, Ravi N Srinivasa
BACKGROUND: The aim of this study was to report the technical and clinical success of performing minimally invasive endolymphatic embolization in neonates presenting with a chylothorax or chylous ascites. METHODS: Three neonates, 2 males and 1 female, with a mean age of 28 days (range: 19-39 days) presented with a chylothorax or chylous ascites that was refractory to conservative management. All 3 patients (1 previously reported) underwent intranodal lymphangiography, followed by thoracic duct embolization, with 1 patient undergoing additional sclerosis of the retroperitoneal abdominal lymphatics...
March 7, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29487653/ultrasound-guided-percutaneous-periarterial-thrombin-injection-for-paracentesis-related-hemoperitoneum
#12
Boya Abudu, David P Duncan, Elliot Deyoung, Gerant Rivera-Sanfeliz
Paracentesis is a common procedure used in the diagnostic evaluation of peritoneal fluid as well as the therapeutic removal of high-volume ascites. Although generally regarded as a safe procedure, complications may arise from arterial injury, including hematomas and pseudoaneurysms. Transcatheter embolization and surgery are first-line interventions for injuries refractory to conservative management. We present a case where a patient failed conventional therapies for hemoperitoneum following a paracentesis which resolved after thrombin injection into the subcutaneous tissues, a novel use for thrombin...
February 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29480862/refractory-chyle-leakage-after-laparoscopic-cholecystectomy-for-gallstone-disease-a-case-report-and-literature-review
#13
REVIEW
Bao Z Yao, Liang Li, Ming Jiang, Jie Wang, Jun Zhang
RATIONALE: Gallstone disease is commonly worldwide and safely treated by laparoscopic cholecystectomy. Chylous ascites is a rare but serious complication of many abdominal operations. PATIENT CONCERNS: We present a rare case of refractory chyle leakage post-LC for acute cholecystitis that is successfully treated in a 40-year-old man, and review current literature on the prevalence, diagnosis, and management of this complication. DIAGNOSES: Refractory chyle leakage post-LC, a rare but serious complication after laparoscopic cholecystectomy...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29471569/does-transjugular-intrahepatic-portosystemic-shunt-stent-differentially-improve-survival-in-a-subset-of-cirrhotic-patients
#14
Jonel Trebicka
Does transjugular intrahepatic portosystemic shunt stent (TIPS) improve survival in a subgroup of patients? Yes. TIPS nearly halves portal pressure and increases the effective blood volume. In cases of acute variceal hemorrhage and with a high risk of treatment failure, defined as either hepatic venous pressure gradient higher than 20 mm Hg, Child B with active bleeding at the endoscopy, or Child C with less than 14 points, early or preemptive placement of TIPS (within 72 hours) improves survival. Also, in suitable patients with intractable or refractory ascites, TIPS improves survival if placed early in the course of treatment...
February 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29460201/patients-with-refractory-ascites-treated-with-alfapump%C3%A2-system-have-better-health-related-quality-of-life-as-compared-to-those-treated-with-large-volume-paracentesis-the-results-of-a-multicenter-randomized-controlled-study
#15
Maria Stepanova, Fatema Nader, Christophe Bureau, Danielle Adebayo, Laure Elkrief, Dominique Valla, Markus Peck-Radosavljevic, Anne McCune, Victor Vargas, Macarena Simon-Talero, Juan Cordoba, Paolo Angeli, Silvia Rossi, Stewart MacDonald, Jeroen Capel, Rajiv Jalan, Zobair M Younossi
BACKGROUND: Refractory ascites (RA) is a complication of cirrhosis which is treated with large volume paracentesis (LVP) as the standard of care. Alfapump® system is a fully implantable pump system which reduces the need for LVP. The aim was to assess health-related quality of life (HRQL) in patients treated with alfapump® versus LVP. METHODS: The data were collected in a multicenter open-label randomized controlled trial (clinicaltrials.gov #NCT01528410). Subjects with cirrhosis Child-Pugh class B or C accompanied by RA were randomized to receive alfapump® or LVP...
February 19, 2018: Quality of Life Research
https://www.readbyqxmd.com/read/29437735/successful-treatment-of-extensive-splanchnic-vein-thrombosis-in-a-patient-with-mycosis-fungoides
#16
Nishtha Sanjay Nagral, Vijay Waman Dhakre, Nirzar Parikh, Shaji Marar
A 33-year-old man of a Middle Eastern origin presented to us with abdominal pain and distension secondary to refractory ascites of 1-month duration. The patient had a history of taking oral retinoic acid 25 mg for 4 months for mycosis fungoides. Investigations revealed thrombosis of hepatic veins with extensive thrombosis of the porto-mesenteric axis. A combination of transjugular intrahepatic portosystemic shunt, balloon angioplasty and thrombolysis with recombinant tissue plasminogen activator was successfully used to treat his condition...
February 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29427779/successful-laparoscopic-treatment-of-chylous-ascites-after-pelvic-lymphadenectomy-a-case-report-and-peanut-oil-application
#17
Junxiu Liu, Huanxiao Zhang, Qiqiao Du, Shuzhong Yao
A 23-year-old female patient with refractory chylous ascites was successfully treated with laparoscopic ligation of the ruptured lymphatic vessel. The young patient developed abdominal distention after right-side pelvic lymph node dissection for dysgerminoma of the right ovary. Conservative managements failed to control the symptoms. Laparoscopic surgery was performed after oral administration of peanut oil, revealing the presence of a whitish fluid in the abdominal cavity. The responsible lesion of the chylous ascites was detected in the right obturator fossa and ligated with the HEM-O-LOK System (Kangji Medical Instrument Co...
February 7, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29427281/idiopathic-chylous-ascites-in-a-patient-with-hiv-infection-response-to-total-parenteral-nutrition-and-octreotide-therapy
#18
Gonçalo Nunes, Cristina Fonseca, Rita Barosa, Marta Patita, André Gomes, Júlio Botas, Hélder Coelho, Maria José Brito, Jorge Fonseca
The authors describe a 47-year-old man infected with human immunodeficiency virus admitted for ascites and weight loss. Ascitic fluid analysis revealed chylous ascites (triglycerides 444 mg/dl) with negative microbiological tests. Neoplasia, cardiac disease and liver cirrhosis were excluded after an extensive diagnostic workout. Exploratory laparotomy with tissue sampling did not clarify ascites etiology. During hospital admission, patient status gradually deteriorated, severe malnutrition developed and ascites became refractory to diuretics...
February 9, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29411988/complete-splenic-embolization-for-the-treatment-of-refractory-ascites-after-liver-transplantation
#19
Oana Anisa Nutu, Iago Justo Alonso, Alberto Alejandro Marcacuzco Quinto, Jorge Calvo Pulido, Luis Carlos Jiménez Romero
Refractory ascites is an uncommon complication that may develop postoperatively after liver transplantation. The diagnosis and treatment of this condition is a real challenge. We report two cases of patients who underwent a transplant due to cryptogenic cirrhosis and developed refractory ascites during the immediate postoperative period. This is a serious complication associated with decreased survival by up to one year and a reduced quality of life. After ruling out the main causes of ascites, a portal hyperflow was a potential etiology...
April 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29411667/prognosis-of-patients-with-ascites-after-pleurx-insertion-an-observational-study
#20
Agnete Nordheim Riedel, Nina Kimer, Lise Hobolth, Lise Lotte Gluud
OBJECTIVE: To evaluate the safety of PleurX in cirrhotic patients with refractory ascites. METHODS: We prospectively registered patients who received a PleurX catheter cirrhosis-associated refractory ascites at our department from July 2015 to November 2016. Our control group consisted of matched cirrhotic patients with refractory ascites treated with large volume paracentesis (LVP) and patients with malignant ascites treated with PleurX during the same period. RESULTS: We included 25 patients with cirrhosis-related ascites (7 in PleurX group) and 17 with malignant ascites (14 in PleurX group)...
March 2018: Scandinavian Journal of Gastroenterology
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