Chylous ascites secondary to cirrhosis of the liver: A case report.

نویسندگان

  • J P Piña-Pedraza
  • L Álvarez-Avalos
  • J M Vargas-Espinosa
  • A Salcedo-Gómez
  • J Carranza-Madrigal
چکیده

285 Upper gastrointestinal lesions secondary to Crohn's disease become resistant to treatment in up to 21% of the cases, have complete clinical and endoscopic remission in 57%, and present at least one relapse of symptoms and lesions in 21%. 10 In our case, medical treatment was established after the procedure, resulting in lesion and symptom remission. And finally, we can conclude that oropharyngeal and esophageal involvement in Crohn's disease is rare and represents a diagnostic challenge due to the scant specificity of the clinical manifestations (aphthous ulcers), as well as the histologic findings (absence of granulomas), and also to the limited value of endoscopy and biopsy in that location, leading to late diagnosis with the consequent therapeutic and prognostic implications. In cases such as ours, with oral lesions that do not respond to symptomatic treatment, with no accurate diagnosis , and with a biopsy excluding malignancy, the possibility of inflammatory bowel disease should be considered. Endo-scopic and colonoscopic studies directed at discovering associated lesions primarily in the terminal ileum should be performed to make a correct diagnosis and begin early medical treatment. In this manner, remission is achieved and the progression into more advanced forms of the disease or the appearance of complications that require surgical treatment in a clinical situation of greater morbidity and mortality for the patient are prevented. The authors declare that there is no conflict of interest. References 1. Sakuraba A, Iwao Y, Matsuoka K, et al. Endoscopic and patho-logic changes of the upper gastrointestinal tract in Crohn's disease. A, et al. Relationship between prox-imal Crohn's disease location and disease behavior and surgery: A cross-sectional study of the IBD Genetics Consortium. SM. Oropharyngeal and proximal esophageal involvement during adalimumab treatment of Crohn disease. ଝ Ascitis quilosa secundaria a cirrosis hepática. Reporte de un caso Chylous ascites is a rare cause of ascites resulting from the accumulation of lymph in the abdominal cavity. It has different etiologies that interrupt the lymphatic flow. Diagnosis is made when a milky or turbid fluid is observed, with a triglyceride concentration ≥ 110 mg/dl. 1,2 The diagnostic criterion for some authors is a serum triglyceride to fluid ratio > 1.0, a cholesterol ratio < 1.0, a leukocyte count ≥ 300 cells/mm 3 , and/or a predominance of lymphocytes with negative culture and cytology. 3 Its incidence varies from 1 in 20,000 to 1 in 187,000 referral hospital admissions. 2,4 Its causes …

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Liver cirrhosis with chylous hydrothorax and ascites: a case report and literature review

To study the clinical manifestations, pathogenesis, and treatment of liver cirrhosis with chylous hydrothorax and ascites. Methods: A case of liver cirrhosis with chylous hydrothorax and ascites was reported and the related literature was reviewed. Results: The patient was hospitalized due to massive ascites. Paracentesis and a low-fat diet were effective. Diuretics, liver protection-therapy, a...

متن کامل

Transjugular intrahepatic portosystemic shunt for chylous ascites in a patient with recurrent cirrhosis following liver transplantation

Chylous ascites (CA) is the extravasation of lipid-rich lymphatic fluid into the peritoneal space following trauma or obstruction of the lymphatic system. Refractory cases of cirrhosis-related CA may be amendable to transjugular intrahepatic portosystemic shunting (TIPS). We present a case of TIPS in the setting of refractory CA secondary to cirrhosis of a transplanted liver graft. Following TI...

متن کامل

Incidental Chylous Ascites at the Time of Cesarean Section

Chylous ascites has multiple etiologies including malignancies, liver cirrhosis, intraperitoneal infections, and trauma. It is rarely reported in pregnancy. We report a case of chylous ascites noted at the time of cesarean section performed at 35 weeks of gestation on a patient with preeclampsia and suspected placental abruption. The diagnosis and treatment of chylous ascites as well as the pre...

متن کامل

Chronic Pancreatitis Associated with Chylous Ascites Simulating Liver Cirrhosis

Purpose. Ascites, esophageal varicose veins, and acute digestive bleeding are unusual in the clinical presentation of chronic pancreatitis; however, these symptoms are frequently observed in patients with liver cirrhosis. Moreover, it is unlikely to observe chylous ascites in both presentations. Method. We report a patient who presented with chronic pancreatitis with splenic vein thrombosis, ne...

متن کامل

Indian Childhood Cirrhosis: Case Report and Pediatric Diagnostic Challenges

Introduction: Indian childhood cirrhosis is a chronic liver disease usually seen in paediatric age group and is unique to the Indian subcontinent. The definitive causative factor for the disease is not found till now but excess copper ingestion has been associated with it.Case presentation: An Indian origin one and half year old premorbidly normal male child presented with history of gradual di...

متن کامل

Chylous Ascites Secondary to Giant Liver Hemangioma

Chylous ascites is rare in clinical practice. It is characterized by milky-appearing peritoneal fluid with a triglycerides concentration of >1.25 mmol/l (110 mg/dl). Its pathophysiology is related to a disruption in the normal lymphatic flow. It is more common after trauma (including post surgery), neoplasia or atypical infections such as tuberculosis or filariasis. Other rare medical causes ha...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Revista de gastroenterologia de Mexico

دوره 80 4  شماره 

صفحات  -

تاریخ انتشار 2015