PDF(Pubmed)
Abstract：
Ascites is defined as a massive collection of fluid in the peritoneal cavity, and it is most commonly caused by portal hypertension due to liver cirrhosis, acute liver failure, and heart failure. We report a case of ascites in a 39-year-old male who presented to the ED complaining of abdominal distention, sporadic pain on the epigastric area, unintentional weight loss over the past two months, night sweats, and blood-mixed stool. We conducted several imaging investigations and laboratory studies and none of them revealed any significant findings except for the abdominal CT with contrast, which showed large ascites along with submucosal fat deposition in the long segment of the transverse colon, suggestive of chronic inflammation [probably inflammatory bowel disease (IBD)], omental caking, and thickening. Peritoneal malignancy was highly suspected. A diagnostic/therapeutic paracentesis was performed, through which 8 L of fluid was drained. Cytology was also performed and this showed mostly reactive mesothelial cells, negative acid-fast bacilli (AFB) culture, and negative polymerase chain reaction (PCR). We also discuss the other investigations performed, none of which helped in establishing a diagnosis.
摘要：
腹水被定义为腹腔中大量的液体，最常见的是肝硬化导致的门静脉高压症,急性肝功能衰竭,和心力衰竭。我们报告了一例腹水病例，其中一名39岁的男性出现在ED，主诉腹胀，上腹部散发的疼痛，在过去的两个月里无意中减肥，盗汗,和混血大便。我们进行了一些影像学检查和实验室研究，除了腹部CT造影外，没有发现任何重要的发现。在横结肠的长段显示大量腹水和粘膜下脂肪沉积，提示慢性炎症[可能是炎症性肠病（IBD）]，网膜结块,和增厚。高度怀疑腹膜恶性肿瘤。进行了诊断/治疗性穿刺,通过它排出8升流体。还进行了细胞学检查，这显示主要是反应性间皮细胞，阴性抗酸杆菌（AFB）培养，和阴性聚合酶链反应(PCR)。我们还讨论了其他调查，这些都没有帮助确定诊断。
