MyMedR

Fulltext Primary lymphangiomyomatosis with chylous ascites

Abdul-Rahman I, Tay SK, Meah FE, Abdullah T

Med J Malaysia, 1994 Jun;49(2):179-81.

Primary lymphangiomyomatosis is a benign tumour of lymphatic channels and lymph nodes, clinically manifested by chylous ascites. This disease is usually progressive and unresponsive to surgery, chemotherapy or irradiation. A case of a 36-year-old lady with chylous ascites due to underlying primary lymphangiomyomatosis is reported.

Matched MeSH terms: Chylous Ascites/etiology*; Chylous Ascites/therapy

Neonatal chylous ascites--report of three cases and review of the literature

Chye JK, Lim CT, Van der Heuvel M

Pediatr Surg Int, 1997 Apr;12(4):296-8.

PMID: 9099650

Three cases of neonatal chylous ascites (CCA) were managed in the neonatal unit, University Hospital, Kuala Lumpur, over the past 9 years. Fetal ascites and polyhydramnios were the sole abnormalities detected in all three babies by antenatal ultrasonography. They were born at 36 weeks' gestation and their birth weights ranged from 3.0 kg to 3.8 kg. All three infants had abdominal distension at birth. Milky ascitic fluid was obtained after starting enteral feedings. Analysis of the ascitic fluid revealed a raised white blood cell count (predominantly lymphocytic) and triglycerides (1.4 - 3.8 mmol/l), cholesterol (1.6 - 2.8 mmol/l), and protein levels (25 - 41 g/l). Conservative management with skimmed milk and medium-chain triglycerides in one infant and Pregestimil in another was instituted. these two infants with CCA were clinically normal when reviewed at 19 months and 3.5 years of age. The third infant had a gut malrotation and associated pyloric septum; he died from complications of a laparotomy. The literature on this rare condition is reviewed.

Matched MeSH terms: Chylous Ascites/congenital*; Chylous Ascites/diagnosis; Chylous Ascites/epidemiology; Chylous Ascites/therapy

Fulltext Unusual case of ascites secondary to unilateral distal ureteric obstruction in an infant

Chinnadurai AV, Hong JSS, Abdul Latif H

BMJ Case Rep, 2022 Jan 17;15(1).

PMID: 35039339 DOI: 10.1136/bcr-2021-243949

Congenital obstructive uropathy is a rare cause of ascites in infants. Majority of reported cases of genitourinary causes of ascites were due to posterior urethral valve. Here, we report a 6-month-old boy who presented with progressive tense ascites and peritonitis attributed by unilateral left distal ureteric obstruction and acute pyonephrosis. He underwent left nephrostomy placement, after which there was a remarkable improvement of ascites. He then underwent left ureteral diversion procedure a month later with a tentative plan for ureteral reanastomosis in 6 months. To date, there are no reports describing ascites secondary to distal ureteric obstruction beyond the neonatal period. The objective of this case report is to highlight unilateral urinary tract obstruction as a potential cause of transudative ascites. Additionally, the superimposed infection in the obstructed collecting system can lead to acute peritonitis likely due to translocation of bacteria into the peritoneal cavity.

Matched MeSH terms: Ascites/etiology

Fulltext Comparison of clinical and laboratory characteristics between severe and non-severe dengue in paediatrics

Idrus NL, Md Jamal S, Abu Bakar A, Embong H, Ahmad NS

PLoS Negl Trop Dis, 2023 Dec;17(12):e0011839.

PMID: 38113250 DOI: 10.1371/journal.pntd.0011839

BACKGROUND: The timely identification of severe dengue in peadiatric patients is of utmost importance, as any delay in diagnosis could lead to an irreversible state of shock potentially leading to fatal consequences. The primary aim of our study was to characterize dengue severity in paediatric patients based on initial symptoms, signs, and laboratory investigation of their presentation in the emergency department.

METHODOLOGY: We conducted a retrospective data retrieval from the medical records of 254 paediatric patients who had been diagnosed with confirmed cases of dengue fever. The clinical characteristics were compared between severe and non-severe dengue. Multiple logistic regression analysis was utilised to elucidate the variables that exhibited associations with severe dengue.

RESULTS: A total of 254 paediatric patients were included, among whom 15.4% (n = 39) were diagnosed with severe dengue. Multiple logistic regression analysis identified lethargy, systolic blood pressure (SBP) below 90 mmHg, capillary refilled time (CRT) longer than 2 seconds, ascites, and hepatomegaly were independently associated with severe dengue.

CONCLUSION: In paediatric patients, severe dengue is associated with specific clinical indicators, including lethargy, low systolic blood pressure, prolonged capillary refill time (CRT), and the presence of ascites and hepatomegaly. Identifying these clinical features early is crucial for primary care physicians, as it enables accurate diagnosis and timely intervention to manage severe dengue effectively.

Matched MeSH terms: Ascites

Chylous ascites after anterior resection for rectal carcinoma: a rare but significant incident

Chan KY, Teoh CM, Sukumar N

Asian J Surg, 2006 Jan;29(1):46-8.

PMID: 16428100

Chylous ascites specifically after anterior resection for rectal cancer has not been documented in the literature thus far. All previously reported postoperative chylous ascites developed in other types of malignancies and were diagnosed within a few days of surgery. However, the patient we report had symptoms 2 years after surgery. Intraoperatively, chylous ascites was found with multiple lymph node metastasis in the small bowel mesentery and retroperitoneal region. The rarity of chylous ascites after anterior resection in rectal carcinoma is documented and discussed.

Matched MeSH terms: Chylous Ascites/etiology*

Case report of neonatal ascites (urinary) due to obstructive uropathy

Devadason I

Med J Malaysia, 1976 Mar;30(3):243-4.

PMID: 986534

Matched MeSH terms: Ascites/etiology*

Dystocia caused by congenital hydronephrosis

Ng KH, Sivanesan S

Med J Malaysia, 1973 Dec;28(2):118-9.

PMID: 4276267

Matched MeSH terms: Ascites/etiology

Fulltext Lymphangioleiomyomatosis with chylous ascites

Raymond AA, Isa MR, Abdullah T, Kudva MV

Singapore Med J, 1993 Jun;34(3):276-8.

PMID: 8266193

A 41-year-old Malay housewife presented with recurrent chylous ascites and progressive cachexia over 17 years. A diagnosis of lymphangioleiomyomatosis (LAM) was established by laparotomy where biopsy of the liver, peritoneum and adhesions from previous surgery showed smooth muscle proliferation in the blood vessels and lymphatics. Clinically and radiologically, there was no evidence of pulmonary involvement. She was treated with dietary fat restriction and medium-chain triglycerides. This is the first case of LAM reported in Malaysia.

Matched MeSH terms: Chylous Ascites/pathology*

Tunneled catheter (PleurX) for long-term chest and abdominal drainages from 2012-2017 in a tertiary institution

H'ng MWC, Leow KS

Med J Malaysia, 2019 08;74(4):352-354.

PMID: 31424051

The PleurX catheter was developed to facilitate long-term intermittent drainage of malignant pleural effusion or ascites. For palliation, it is important that the process of insertion is safe and that this catheter remains complicationfree so as to improve end-of-life quality. We show that this catheter can be safely inserted and discuss methods to reduce infection, which was the most common complication. Our article hopes to enlighten clinicians, patients and their caregivers of this device as a treatment option in palliative patients. Proper case selection and caregiver training are essential in ensuring a successful outcome.

Matched MeSH terms: Ascites/etiology; Ascites/therapy*

Fulltext Intestinal lymphangiectasia--a report of three Chinese children in Malaysia

Lee WS, Boey CC, Goh AY, Chang KW, Iyngkaran N

Singapore Med J, 1998 Sep;39(9):418-21.

PMID: 9885723

This is a report of 3 Chinese children with intestinal lymphangiectasia in Malaysia. Two children responded to a low fat diet and medium-chain triglyceride supplement. The third child has recurrent chylous ascites. None of the children has recurrent infections despite low CD4+ cells and low levels of IgG and IgA. Intestinal lymphangiectasia is a rare congenital disorder of the mesenteric lymphatic that leads to the obstruction of the lymphatics of the intestine and protein losing enteropathy. Restriction of dietary fat intake will usually result in remission. Recurrent chylous ascites is a problem and management can be difficult.

Matched MeSH terms: Chylous Ascites/etiology; Chylous Ascites/therapy

Cullen and Grey Turner signs in abdominal pain

Chuah YY, Lee YY

Med J Aust, 2021 03;214(4):164.

PMID: 33458825 DOI: 10.5694/mja2.50924

Matched MeSH terms: Ascites/complications; Ascites/diagnosis*

Surgical ascites

Nadarajah C

Journal of the Malaya Branch of the British Medical Association, 1940;3:423-4.

Matched MeSH terms: Ascites

Quantitative comparisons of lung structure of adult domestic fowl and red jungle fowl, with reference to broiler ascites

Vidyadaran MK, King AS, Kassim H

Avian Pathol, 1990 Jan;19(1):51-8.

PMID: 18679913

A stereological comparison has been made of the structure of the lungs of the adult female domestic fowl and its wild progenitor the Red Jungle Fowl. The volume of the lung per unit body weight of the domestic bird is between 20 and 33% smaller than that of the wild bird. The domestic fowl has partly compensated for this by increasing the surface area for gas exchange per unit volume of exchange tissue. However, the blood-gas tissue barrier is about 28% thicker in the domestic fowl than in the Red Jungle Fowl, and this has led to a 25% lower anatomical diffusing capacity for oxygen of the blood-gas tissue barrier per unit body weight in the domestic fowl. These structural characteristics may make the modern domestic fowl vulnerable to stress factors such as altitude, cold, heat or air pollution by predisposing to hypoxaemia and perhaps thence to ascites.

Matched MeSH terms: Ascites

Spontaneous bacterial peritonitis [SBP]

Chutaputti A

Med J Malaysia, 2005 Jul;60 Suppl B:12-4.

PMID: 16108166

Matched MeSH terms: Ascites/complications

Fulltext A case of chronic myeloid leukaemia in blast transformation with leukemic ascites

Mohd Ridzuan MS, Yap E, Wan Fariza WJ, Fadilah SA, Salwati S

Med J Malaysia, 2016 04;71(2):85-7.

PMID: 27326952 MyJurnal

Chronic Myeloid Leukaemia (CML) is a disease characterised by a distinctive marker that is the Philadelphia Chromosome and an ability to transform into blast phase, which confers a poor prognosis. The median survival was reported to be between three to six months in correlation to blast phase. Extramedullary involvement with CML to sites such as pleural, meningeal and bones have been reported. We report a case of 41-year-old man who was diagnosed with CML in blast phase and presented with ascites. Ultrasound of abdomen showed coarse echotexture of liver suggestive leukaemic infiltration to the liver. The liver profile was severely deranged and associated with coagulopathy. Flow cytometry analysis of the peritoneal fluid revealed presence of myeloblasts consistent with CML in blast crisis with leukaemic ascites. Bone marrow biopsy also confirmed disease transformation. He received standard induction chemotherapy for acute myeloid leukaemia with dose modifications based on liver enzymes performance. Our case highlights an unusual presentation of CML in blast crisis with leukaemic ascites and the challenges in managing cytotoxic treatments due to the liver infiltration.

Matched MeSH terms: Ascites/etiology*

The masquerades of female pelvic tuberculosis: case reports and review of literature on clinical presentations and diagnosis

Chow TW, Lim BK, Vallipuram S

J Obstet Gynaecol Res, 2002 Aug;28(4):203-10.

PMID: 12452262

In this review, tuberculosis of the genital tract was diagnosed retrospectively in 11 females over 15 years. The presentations of nine cases are described. Seven of the nine cases presented with ascites, vague abdominal distension, weight loss and were misdiagnosed as ovarian carcinoma. Eight women had no relevant past history. A review on clinical presentations and diagnosis of pelvic tuberculosis is presented. We conclude that although the incidence of tuberculosis is uncommon in developed countries, its prevalence appears to be increasing worldwide. Therefore, clinicians should consider tuberculosis as a differential diagnosis when encountering clinical presentations of pelvic mass and ascites.

Matched MeSH terms: Ascites/etiology

Fulltext Vitamin D deficiency causing eosinophilic esophagogastroenteritis and ascites: a rare association

Qua CS, Peh KB, Saravannan K, Goh KL

BMJ Case Rep, 2021 Feb 04;14(2).

PMID: 33541947 DOI: 10.1136/bcr-2020-240039

A 54-year-old Chinese man presented with ascites for 2 weeks. He had a preceding 2-year history of intermittent dysphagia, lethargy and general malaise. Blood investigations revealed leucocytosis with eosinophilia of 26.5%, whereas paracentesis showed turbid fluid with high protein content (45 g/L) and a high white blood cell count of 5580/µL, predominantly eosinophils (90%). An incidental assay of vitamin D showed a very low level of 13.5 ng/mL. No other cause of ascites was found. Gastroscopy was normal except for duodenitis. However, biopsies from lower oesophagus confirmed the presence of eosinophilic infiltration. Following vitamin D replacement, the patient experienced marked improvement in symptoms of dysphagia within 2 weeks and no recurrence of ascites after 3 months. The reason for the patient's vitamin D deficiency remains unclear. The marked improvement in the patient's health indicates a causative role of vitamin D deficiency in causing eosinophilic esophagogastroenteritis and associated eosinophilic ascites.

Matched MeSH terms: Ascites/complications*

Ultrasound findings of plasma leakage as imaging adjunct in clinical management of dengue fever without warning signs

Xin Tian C, Baharuddin KA, Shaik Farid AW, Andey R, Ridzuan MI, Siti-Azrin AH

Med J Malaysia, 2020 11;75(6):635-641.

PMID: 33219170

INTRODUCTION: Plasma leakage is a major cause of morbidity and mortality in dengue fever. Few studies have shown the sensitivity of thoracoabdominal ultrasound in detecting plasma leakage in severe dengue, however its sensitivity in the early presentation of dengue fever without warning signs remains unknown. This study is aimed to determine the role of serial ultrasound in order to detect plasma leakage in dengue fever without warning signs.

METHODS: This prospective cohort study was conducted at Hospital Universiti Sains Malaysia (USM) from 1st October 2016 to 30th November 2017. Serial bedside ultrasound procedures were performed for 83 patients who were diagnosed as having dengue fever without warning signs and were initially treated as outpatients. Ultrasonography evidence of plasma leakage either pleural effusion, thickened gallbladder wall, ascites or pericardial effusion were compared with clinical findings and laboratory parameters for plasma leakage.

RESULTS: Of the 83 dengue patients, eventually 72.3% had dengue fever with warning signs and 6.0% had severe dengue fever. There were 38 patients who had subclinical plasma leakage at initial presentation, 84.2% and 7.9% of them then progressed to dengue fever with warning signs and severe dengue respectively. There was a minimal agreement between serial bedside ultrasound and haematocrit level in the detection of plasma leakage (observed kappa 0.135).

CONCLUSIONS: Serial bedside ultrasound is an adjunct procedure to physical examination and may detect plasma leakage earlier compared to haemoconcentration. The early usage of serial ultrasound is of paramount importance in detecting dengue patients who are at risk of progressing to severe dengue.

Matched MeSH terms: Ascites

Collision tumor of the ovary: Fibroma and mature cystic teratoma

Tan GC, Chandramaya SF, Noordin A, S Tay PY

Indian J Pathol Microbiol, 2021 1 13;64(1):171-173.

PMID: 33433434 DOI: 10.4103/IJPM.IJPM_670_19

Collision tumor consists of two tumors occurring in the same organ without intermixture of the two cell types. The most common type of collision tumor in ovary is between teratoma and surface epithelial tumor. A 38-year-old woman presented with complained of lower abdominal pain and tightness, and a solid partially cystic left ovarian mass with minimal ascites was detected. Left salpingo-oophorectomy was performed. The ovarian mass measured 15 × 12 × 7 cm with a pedunculated mass on its surface which measured 6 × 2.5 × 2.5 cm. Histologically, it was a collision tumor of fibroma and mature cystic teratoma. Fibroma becomes more edematous as their size increases, which is frequently accompanied by the escape of increasing quantities of fluid from the tumor surfaces. Ascites is often detected when the fibroma is more than a diameter of 10 cm. It is important to identify the different components of a collision tumor for proper management.

Matched MeSH terms: Ascites

Giant urinary bladder with left scrotal swelling: An unusual presentation of chronic urinary retention

Nur Bazlaah B, Nabiha F, Khairuzi S, Amerdad D, Mohd Firdaus H, Ismayudin I

Med J Malaysia, 2020 11;75(6):736-737.

PMID: 33219187

Chronic Urinary Retention (CUR) can be either asymptomatic or associated with lower urinary tract symptoms. There has been no report of case of CUR presented with unilateral scrotal swelling. In the present report, a 69-year-old man came with an abdominal distension and left scrotal swelling. He was initially diagnosed with ascites secondary to a possible malignancy. A diagnosis was established after a computed tomography (CT) scan was done that revealed a giant bladder distension with volume of 10.1 litres. The left scrotal swelling was resolved after catheterization was carried out. There was a possibility that the patient had inferior vena cava obstruction secondary to the huge bladder.

Matched MeSH terms: Ascites

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