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ascites syndrome

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: 1115 stable cirrhotic patients with mild liver and renal dysfunction but varying degrees of ascites severity from 3 previous satavaptan versus 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
Kakharman Yesmembetov, Zhansaya Muratova, Sergey Borovskiy, Irina Ten, Kulpash Kaliaskarova
We report the clinical case of 23-year-old patient with liver cirrhosis of unknown genesis, significant resistant ascites, and 2 episodes of bleeding from esophageal varices. Evaluation did not find any cause of liver disease, and the patient was placed on the transplant wait list due to subcompensated liver function (Model for End-Stage Liver Disease score of 16, Child-Pugh class B) and poorly controlled severe portal hypertension. After treatment with diuretics, largevolume paracentesis, antibiotics, and vasoconstrictors, hepatorenal syndrome and spontaneous bacterial peritonitis resolved and liver function improved significantly...
March 2018: Experimental and Clinical Transplantation
Sapan Kumar Behera, Saibal Das, Alphienes Stanley Xavier, Sandhiya Selvarajan
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a serious and potentially fatal adverse effect to therapeutic medications. The incidence of this condition varies among different ethnicities because of the difference in the genetic makeup. Though fever, rash and eosinophilia are essential features for the diagnosis of this syndrome, these vary from patient to patient along with the involvement of various organs such as liver, kidney, lungs, pancreas, etc. Some of the atypical features are dysphagia, agranulocytosis, and chylous ascites...
March 15, 2018: Hospital Practice (Minneapolis)
Bénédicte Sudrié-Arnaud, Florent Marguet, Sophie Patrier, Jelena Martinovic, Ferielle Louillet, Françoise Broux, Françoise Charbonnier, Hélène Dranguet, Sophie Coutant, Myriam Vezain, Raphaël Lanos, Abdellah Tebani, Maria Fuller, Foudil Lamari, Pascal Chambon, Anne-Claire Brehin, Laetitia Trestard, Isabelle Tournier, Stéphane Marret, Eric Verspyck, Annie Laquerrière, Soumeya Bekri
PURPOSES: Hydrops fetalis is a life-threatening fetal condition, and 85% of all cases are classified as nonimmune hydrops fetalis (NIHF). Up to 15% of NIHF cases may be due to inborn errors of metabolism (IEM), but a large proportion of cases linked to metabolic disorders remains undiagnosed. This lack of diagnosis may be related to the limitations of conventional biological procedures, which involve sequential investigations and require multiple samples and steps. In addition, this approach is time consuming...
February 21, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Gopal Krishana Bohra, Vivek Chhabra, Naresh Midha, Binit Sureka
We report a case of 26-year-old man who was admitted on our ward for the evaluation of ascites. He was a known case of inflammatory bowel disease(ulcerative colitis) and was on regular mesalamine therapy. On evaluation, he was having high serum ascites albumin gradient. CT scan of the abdomen revealed features of portal hypertension and non-visualisation of right and middle hepatic veins along with thrombus in inferior vena cava, suggesting a diagnosis of Budd-Chiari syndrome (BCS). There are only few case reports available showing association of BCS with UC...
February 22, 2018: BMJ Case Reports
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
Shih-Ting Lai, Chih-Ping Chen, Chen-Ju Lin, Chin Yuan Hsu, Peih-Shan Wu, Chen Chi Lee, Chen Wen Pan, Wayseen Wang
OBJECTIVE: We present two cases of late-onset bilateral fetal pleural effusions associated with fetal Down syndrome. CASE REPORTS: Case 1. A 33-year-old Vietnamese woman had undergone regular sonographic examinations since 23 weeks of gestation and no abnormality had been noted. However, bilateral moderate pleural effusions were found at 33 weeks of gestation, and massive pleural effusion, ascites and polyhydramnios developed at 34 weeks of gestation. Aspiration of the pleural effusion was subsequently performed...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
Juan S Rubio, Carolina Rumbo, Pablo A Farinelli, Nicolás Aguirre, Diego A Ramisch, Hugo Paladini, Pablo D Angelo, Pablo Barros Schelotto, Gabriel E Gondolesi
Collateral circulation secondary to liver cirrhosis may cause the development of large PSSs that may steal flow from the main portal circulation. It is important to identify these shunts prior to, or during the transplant surgery because they might cause an insufficient portal flow to the implanted graft. There are few reports of "steal flow syndrome" cases in pediatrics, even in biliary atresia patients that may have portal hypoplasia as an associated malformation. We present a 12-month-old female who received an uneventful LDLT from her mother, and the GRWR was 4...
February 16, 2018: Pediatric Transplantation
A Abbara, R Islam, S A Clarke, L Jeffers, G Christopoulos, A N Comninos, R Salim, S A Lavery, N L Vuong, P Humaidan, T W Kelsey, G H Trew, W S Dhillo
OBJECTIVE: Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic condition, predominantly related to the hormone used to induce oocyte maturation during IVF treatment. Kisspeptin is a hypothalamic neuropeptide that has recently been demonstrated to safely trigger final oocyte maturation during IVF treatment even in women at high risk of OHSS. However to date, the safety of kisspeptin has not been compared to current hormonal triggers of oocyte maturation. DESIGN: We conducted a retrospective single-centre cohort study investigating symptoms and clinical parameters of early OHSS in women at high risk of OHSS (antral follicle count or total number of follicles on day of trigger ≥23) triggered with hCG (n=40), GnRH agonist (GnRHa; n=99), or kisspeptin (n=122) at Hammersmith Hospital IVF unit, London, UK (2013-2016)...
February 15, 2018: Clinical Endocrinology
Georgios N Kalambokis, Ilias Tsiakas, Maria Christaki, Christina Koustousi, Leonidas Christou, Gerasimos Baltayiannis, Dimitrios Christodoulou
BACKGROUND: The aim of this study was to predict the occurrence of hepatorenal syndrome (HRS) and death in patients with advanced cirrhosis and ascites. PATIENTS AND METHODS: We retrospectively evaluated 2-year data of 78 patients with cirrhosis and ascites (Child-Pugh B/C: 45/43). The mean arterial pressure (MAP) and cardiac output (CO) were measured in all patients just before administration of 2 mg of terlipressin and 30 min later. Systemic vascular resistance (SVR) was calculated as MAP/CO...
February 9, 2018: European Journal of Gastroenterology & Hepatology
Shih-Yi Lin, Cheng-Li Lin, Cheng-Chieh Lin, I-Kuan Wang, Wu-Huei Hsu, Chia-Hung Kao
BACKGROUND & AIMS: Until now, no study has investigated the risks of acute coronary syndrome (ACS) and peripheral arterial disease (PAD) in cirrhosis. METHODS: In this study, 57,214 patients diagnosed with cirrhosis between 2000 and 2010 were identified from the Taiwan National Health Insurance claims data. Each patient was randomly selected and frequency-matched with an individual without cirrhosis by age, sex, and index year. RESULTS: The overall incidence rates of ACS and PAD were 2...
February 2, 2018: Atherosclerosis
B Drinkwater, B K Clarke, J Jones, J Ratcliffe, P Deel-Smith, S C Cooper
BACKGROUND AND AIMS: Home parenteral nutrition (HPN) for palliation has little evidence supporting existing guidance. Patient selection remains challenging. We aimed to evaluate use of palliative HPN in our service against ESPEN guidance, and to identify potential prognostic indicators. METHODS: Palliative care patients commenced on HPN were identified. Medical notes, computer records and HPN database were accessed to identify patient demographics, primary diagnosis and aetiology of intestinal failure, blood test results potentially associated with prognosis (eGFR, albumin, CRP, Hb), presence of ascites, and PN duration...
December 2017: Clinical Nutrition ESPEN
Satoshi Nishiwada, Shinji Nakamura, Tetsuya Tanaka, Yuki Kirihataya, Daiki Nezu, Nobuhiro Sawa, Naoki Fujita, Haruka Ikegami, Atsushi Yoshimura
INTRODUCTION: Entero-enteric fistulas are rare complications that occur in patients with inflammatory bowel disease and other intestinal diseases. In this report, we present an ileo-ileal fistula accompanied by severe malnutrition caused by strangulated ileus surgery while preserving the ischemic ileum in a very elderly patient. CASE PRESENTATION: A 90-year-old woman underwent emergency surgery without bowel resection for strangulated ileus in another hospital. Minor abdominal pain and slight fever persisted after surgery...
January 27, 2018: International Journal of Surgery Case Reports
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...
February 7, 2018: Revista Española de Enfermedades Digestivas
Nipun Verma, Shreya Singh, Gitesh Sawatkar, Virendra Singh
Sofosbuvir is an imperative drug used in treatment regimens for hepatitis C virus (HCV). It is considered relatively safe with fewer adverse effects than other treatments. Here, we report a rare and potentially serious, dermatologic, adverse effect following the use of sofosbuvir. A 35-year-old man with genotype 3-related HCV cirrhosis presented with decompensated ascites and jaundice following 7 weeks of therapy with peginterferon alpha-2a and oral ribavirin. After peginterferon withdrawal and stabilization, oral sofosbuvir and ribavirin were started; 10 days later, he developed itching over the trunk and legs, followed by multiple papules and vesicles over an erythematous base...
January 2018: Hepatology Communications
Saliha Yilmaz, Dilek Uludağ Alkaya, Özgür Kasapçopur, Kenan Barut, Ekin S Akdemir, Cemre Celen, Mark W Youngblood, Katsuhito Yasuno, Kaya Bilguvar, Murat Günel, Beyhan Tüysüz
BACKGROUND: The camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP) is a rare autosomal recessive condition characterized by camptodactyly, noninflammatory arthropathy, coxa vara, and pericarditis. CACP is caused by mutations in the proteoglycan 4 (PRG4) gene, which encodes a lubricating glycoprotein present in the synovial fluid and at the surface of articular cartilage. METHODS: In the present study, we compared the clinical and molecular findings of CACP syndrome in 35 patients from 11 unrelated families...
February 4, 2018: Molecular Genetics & Genomic Medicine
Muhammad Yasir, Muhammad Qamarul Hoda, Tauseef Ahmed
Abdominal compartment syndrome (ACS) is increasingly identified in critically ill patient and its harmful effects are well documented. The disparity among the pressure, volume in abdominal cavity and its contents, results in ACS. The actual incidence of ACS is not known. However, it has been observed predominantly in patients with severe blunt and penetrating abdominal trauma, ruptured abdominal aortic aneurysms, retro- and intra-peritoneal hemorrhage, pneumoperitoneum, neoplasm, pancreatitis, ascites and multiple bone fracture...
February 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Giuseppe Brancatelli, Alessandro Furlan, Alberto Calandra, Marco Dioguardi Burgio
Hepatic sinusoidal dilatation refers to the enlargement of the hepatic capillaries. Most of the time this condition is caused by hepatic venous outflow obstruction, which results in vascular stasis and congestion of hepatic parenchyma. In this setting, hepatic sinusoidal dilatation can be related to pericardial disease, heart failure, compression or thrombosis of the hepatic veins or inferior vena cava (i.e., Budd-Chiari syndrome) or central veins/sinusoids involvement (i.e., sinusoidal obstruction syndrome)...
February 1, 2018: Abdominal Radiology
Sayaka Fujiwara, Hideaki Tsuyoshi, Toshiya Nishimura, Nozomu Takahashi, Yoshio Yoshida
BACKGROUND: Struma ovarii is a rare ovarian neoplasm that often appears malignant on conventional imaging. Pseudo-Meigs' syndrome with ascites, pleural effusion, and elevated serum CA 125 levels is much rarer and leads to misdiagnosis of ovarian cancer and unnecessary extended surgery. CASE PRESENTATION: A 50-year-old woman with abdominal distention and dyspnoea was referred to our hospital. Ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) showed a polycystic ovarian tumor with a solid component, pleural effusion, and massive ascites with negative cytology...
February 2, 2018: Journal of Ovarian Research
Lijun Liang, Lei Wang, Panrong Zhu, Youyou Xia, Yun Qiao, Kaiyuan Hui, Chenxi Hu, Yan Ren, Xiaodong Jiang
RATIONALE: Malignant ascites (MA) is one of the poor prognostic factors for advanced pancreatic cancer and can bring about serious symptoms. The improvement of quality of life for patients is priority. However, there is no standard method for the treatment for pancreatic cancer-mediated MA. Apatinib is a novel and highly selective tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor-2. There are no reports of concurrent apatinib with gemcitabine in patients with pancreatic cancer-mediated MA...
November 2017: Medicine (Baltimore)
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