Hemorrhagic ascites endometriosis could be a cause: a case report

Abstract Background Endometriosis is a condition in which tissue similar to the lining inside the uterus (called “the endometrium”) is found outside the uterus, where it induces a chronic inflammatory reaction that may result in scar tissue. Endometriosis with massive ascites causing abdominal distension and other symptoms simulating malignancy has been described in the literature. Case presentation A case of a 27-year-old woman who presented to the Ascites Study Group Tropical Medicine department Ain Shams University in collaboration with the Egyption Club of Ascites (ECA) with increased central abdominal contour, shifting dullness, and hemorrhagic transudate hypocellular ascites with no malignant cells and bilateral ovarian cysts. A long stepwise approach was conducted to the patient, and after exclusion of other causes of hemorrhagic ascites, the patient was prepared for laparoscopy. The diagnosis of endometriosis was made. The patient was discharged on goserelin acetate subcutaneous injection every 28 days with good response, and she regularly follows up with our study group on scheduled visits monthly according to her clinical status. Conclusions Endometriosis could be a possible cause of massive hemorrhagic obscured ascites. The unexplained infertility should increase the probability of the endometriosis.

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Successful treatment of hepatic lymphorrhea by percutaneous transhepatic lymphangiography followed by sclerotherapy using OK-432

Surgical Case Reports ◽

10.1186/s40792-019-0761-z ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Masayuki Kojima ◽

Masanori Inoue ◽

Seiichiro Yamamoto ◽

Toshio Kanai ◽

Seishi Nakatsuka ◽

...

Keyword(s):

Computed Tomography ◽

Rare Case ◽

Intraperitoneal Administration ◽

Lymphatic Vessels ◽

Hepatoduodenal Ligament ◽

Massive Ascites ◽

Case Presentation ◽

Successful Case ◽

Leakage Site ◽

And Control

Abstract Background Conventional lymphangiography cannot detect leakage sites of hepatic lymphatic vessels. Percutaneous transhepatic lymphangiography can be used to visualize leakage sites, and once the leakage site has been confirmed, effective sclerotherapy can be performed. Case presentation A rare case of intractable hepatic lymphorrhea due to injury of the hepatoduodenal ligament following pancreaticoduodenectomy is reported. Drainage of massive ascites from the drainage tube continued after surgery. Percutaneous transhepatic lymphangiography visualized the intrahepatic lymphatic vessels and the leakage site at the hepatic hilum. An 8-Fr drainage catheter was inserted adjacent to the leakage point under fluoroscopic computed tomography guidance. Repeated sclerotherapy using intraperitoneal administration of OK-432 (picibanil) through the catheter was performed, which exposed the leakage site, and control of the ascites was finally achieved. Conclusions To the best of our knowledge, this is the first successful case of detection of a leakage site using intrahepatic lymphangiography, followed by sclerotherapy using OK-432.

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Is Chronic Inflammation a Possible Cause of Obesity-Related Depression?

Mediators of Inflammation ◽

10.1155/2009/439107 ◽

2009 ◽

Vol 2009 ◽

pp. 1-4 ◽

Cited By ~ 7

Author(s):

Magdalena Olszanecka-Glinianowicz ◽

Barbara Zahorska-Markiewicz ◽

Piotr Kocełak ◽

Joanna Janowska ◽

Elżbieta Semik-Grabarczyk ◽

...

Keyword(s):

Chronic Inflammation ◽

Severe Depression ◽

Study Groups ◽

Study Group ◽

Serum Concentrations ◽

Obese Women ◽

Adult Obesity ◽

Mild Depression ◽

Depression Level ◽

Possible Cause

Adult obesity has been associated with depression, especially in women. Whether depression leads to obesity or obesity causes depression is unclear. Chronic inflammation is observed in obesity and depression. In 63 obese women without additional diseases depression level was assessed with the Beck's questionnaire. After evaluation of depression level study group was divided into groups according to the mood status (A—without depression, B—mild depression, and C—severe depression), and serum concentration of TNF-α, sTNFs, leptin, and IL-6 were measured by ELISA. No differences in age, body mass, BMI, and body composition were observed in study groups. We did not observe differences of serum concentrations of TNF-α, sTNFRs, leptin, and IL-6 between subgroup A and subgroups B and C. It seems that circulating adipokines did not exert influence on depression levels in obese women.

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Duplication of Inferior Vena Cava, Possible Cause of Internal Hernia? Literature Review and Rare Case Presentation

Chirurgia ◽

10.21614/chirurgia.115.5.665 ◽

2020 ◽

Vol 115 (5) ◽

pp. 665

Author(s):

Cedric Kwizera ◽

Daniel G. Popa ◽

Marian Botoncea ◽

Adrian Tudor ◽

Gyorgy D. Szava ◽

...

Keyword(s):

Literature Review ◽

Inferior Vena Cava ◽

Internal Hernia ◽

Rare Case ◽

Inferior Vena ◽

Vena Cava ◽

Case Presentation ◽

Possible Cause

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Maternal iodine excess: an uncommon cause of acquired neonatal hypothyroidism

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2018-0138 ◽

2018 ◽

Vol 31 (9) ◽

pp. 1061-1064 ◽

Cited By ~ 2

Author(s):

Tyler Hamby ◽

Nayana Kunnel ◽

John S. Dallas ◽

Don P. Wilson

Keyword(s):

Newborn Screening ◽

Growth And Development ◽

Short Term ◽

Neonatal Hypothyroidism ◽

Case Presentation ◽

Iodine Excess ◽

Excessive Iodine ◽

Possible Cause

AbstractBackgroundExcessive iodine exposure is an often overlooked cause of neonatal hypothyroidism.Case presentationWe present an infant with iodine-induced hypothyroidism, which was detected at age 15 days by newborn screening. The infant’s iodine excess resulted from maternal intake of seaweed soup both during and after pregnancy. Treatment included discontinuation of seaweed soup, temporary interruption of breastfeeding and short-term levothyroxine therapy. By age 4 months, the infant’s hypothyroidism had resolved, and her growth and development were normal.ConclusionsThis case illustrates the importance of considering excess dietary iodine as a possible cause of hypothyroidism in infants.

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A case of severe SARS-CoV-2 infection with negative nasopharyngeal PCR in pregnancy

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2020-0075 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Anna Fuchs ◽

Lauren Harris ◽

Ashley Huber ◽

Mia Heiligenstein ◽

Cassandra Heiselman ◽

...

Keyword(s):

Clinical Presentation ◽

Clinical Status ◽

Igg Antibodies ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Case Presentation ◽

Preterm Premature Rupture ◽

High Clinical Suspicion ◽

Maternal Status

Abstract Objectives SARS-CoV-2 remains a pressing issue for our obstetric community during the current pandemic. We present a case of a 22-year-old nulliparous woman 31 weeks pregnant, with significant clinical SARS-CoV-2 disease, in the setting of negative nasopharyngeal PCR testing but positive IgG antibodies. Case presentation This was a 22-year-old patient 31 weeks pregnant who presented with fever, tachycardia, and subsequently preterm premature rupture of membranes (PPROM) and pulmonary emboli with multifocal pneumonia. The patient underwent three negative SARS-CoV-2 tests via nasopharyngeal PCR testing during her hospital stay as well as a negative workup for fever. After a cesarean section for worsening maternal status after 7 days of hospitalization, the patient was admitted for worsening clinical status to the SICU. At the time of SICU admission patient was found to have serum IgG positive antibodies and was managed with intubation, antibiotics, and anticoagulation. Patient eventually left hospital against medical advice on hospital day 16 on oral antibiotics but was found to be recovering well at later outpatient follow up. Conclusions Diagnosis of SARS-CoV-2 remains a complicated picture in the setting of testing limitations. This case highlights an antepartum clinical presentation of severe SARS-CoV-2 and recommends a high clinical suspicion for diagnosis of SARS-CoV-2 and initiation of treatment in the pregnant population, even in the presence of negative nasopharyngeal PCR testing.

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Maintenance with Trabectedin in the Treatment of Platinum-Sensitive Recurrent Ovarian Cancer

Case Reports in Oncology ◽

10.1159/000500411 ◽

2019 ◽

Vol 12 (2) ◽

pp. 447-455 ◽

Cited By ~ 1

Author(s):

Eva María Guerra Alía ◽

Cayetano Sempere Ortega ◽

Alfonso Cortés Salgado ◽

Concepción Sanchez Martínez ◽

Julio Galindo Álvarez ◽

...

Keyword(s):

Ovarian Cancer ◽

Pegylated Liposomal Doxorubicin ◽

Abdominal Distension ◽

Recurrent Ovarian Cancer ◽

Response To Treatment ◽

Case Presentation ◽

Good Tolerance ◽

Platinum Sensitive ◽

Platinum Based Chemotherapy ◽

Selection Of

Ovarian cancer is the seventh most common type of cancer and the fifth leading cause of cancer death among women worldwide. The current usual therapeutic approach in this disease includes optimal cytoreductive therapy followed by platinum-based adjuvant chemotherapy, along with neoadjuvant chemotherapy prior to surgery in selected cases. The platinum-free interval (PFI) continues to be the most useful tool to assist in the selection of the subsequent therapy and to predict response to treatment. The combination of trabectedin and pegylated liposomal doxorubicin (PLD) is useful in patients with partially platinum-sensitive recurrent ovarian cancer, in patients who have previously received two or more platinum-based chemotherapy regimens, in patients who have already experienced a platinum-induced hypersensitivity reaction and in patients who have previously failed to respond to a platinum-based treatment. Case Presentation: A 64-years-old postmenopausal woman with pain, abdominal distension, and an altered intestinal transit and with partially platinum-sensitive recurrent ovarian cancer, was successfully treated with a second line of trabectedin chemotherapy in combination with PLD, followed by trabectedin in monotherapy. This case proves the effectiveness of the combination of trabectedin and PLD and demonstrates how the administration of trabectedin, even in monotherapy, allows to maintain an adequate clinical response with good tolerance to the treatment during more than two years of drug administration.

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Nivolumab for malignant peritoneal mesothelioma

BMJ Case Reports ◽

10.1136/bcr-2020-237721 ◽

2020 ◽

Vol 13 (11) ◽

pp. e237721

Author(s):

Takaaki Tanaka ◽

Yosuke Miyamoto ◽

Atsue Sakai ◽

Nobukazu Fujimoto

Keyword(s):

Bowel Obstruction ◽

Biopsy Specimen ◽

Poor Prognosis ◽

Malignant Neoplasm ◽

Abdominal Distension ◽

Peritoneal Mesothelioma ◽

Malignant Peritoneal Mesothelioma ◽

Massive Ascites ◽

Shipbuilding Industry ◽

The Third

Malignant peritoneal mesothelioma (MPeM) is a highly malignant neoplasm of the peritoneum, which carries a poor prognosis. A 70-year-old man, who was employed in the shipbuilding industry and exposed to asbestos for 50 years, was found to have a low-density lesion in the peritoneum around the liver and spleen, associated with multiple mediastinal and parasternal lymphadenopathy. Laparoscopic exploration was performed, and biopsy specimen analysis led to a diagnosis of MPeM. Initial systemic chemotherapy comprising cisplatin and pemetrexed yielded a modest cytoreductive effect. However, 4 months later, the patient presented with abdominal distension and anorexia. CT images revealed massive ascites, bowel obstruction and an enlarged intra-abdominal tumour, which was considered progression of the MPeM. The patient was treated with nivolumab. Bowel obstruction was improved after the first administration, and his sense of abdomen distension completely disappeared after the third administration. This case supports the utility of immunotherapy in MPeM.

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Surgical procedure of segmentectomy as a possible cause of postoperative cerebral embolism: a case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01378-7 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Peirui Chen ◽

Qiusha Qing ◽

Mingqiang Diao ◽

Xiaokang Sun ◽

Junrong Yang ◽

...

Keyword(s):

Postoperative Period ◽

Surgical Procedure ◽

Mechanical Thrombectomy ◽

Early Postoperative Period ◽

Cerebral Embolism ◽

Case Presentation ◽

Early Symptom ◽

Life Threatening ◽

Pulmonary Vein Stump ◽

Possible Cause

Abstract Background Cerebral embolism after lobectomy is a life-threatening complication during the early postoperative period. However, it is unclear if cerebral embolism can develop after segmentectomy. Case presentation We experienced a case of a 37-year-old man who demonstrated early symptom of acute ischemic stroke in early postoperative period after right upper posterior segmentectomy and performed intra-arterial mechanical thrombectomy (IAMT) successfully. Conclusions Long and irregular pulmonary vein stump (PVS) and endothelial injury caused by surgical procedure may lead to cerebral embolism after segmentectomy. We believe that doing preoperative pulmonary vascular assessment and using appropriate surgical procedure may reduce the rate of cerebral embolism.

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Reactive changes in the adolescent porcine spine with disc degeneration due to endplate injury

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0037-1616581 ◽

2007 ◽

Vol 20 (01) ◽

pp. 12-17 ◽

Cited By ~ 11

Author(s):

A. Baranto ◽

A. Kaigle Holm ◽

L. Ekström ◽

L. Swärd ◽

T. Hansson ◽

...

Keyword(s):

Blood Vessels ◽

Nucleus Pulposus ◽

Disc Degeneration ◽

Annulus Fibrosus ◽

Scar Tissue ◽

Vertebral Endplate ◽

Lumbar Intervertebral Disc ◽

Physiological Loading ◽

Reactive Changes ◽

Chronic Inflammatory Reaction

SummaryDegenerative and reactive structural alterations occurring after experimentally-induced disc degeneration were evaluated using a porcine model. A cranial perforation was made through the L4 vertebral endplate into the nucleus pulposus. Three months later, the lumbar intervertebral disc and adjacent vertebrae were dissected, fixed in formalin and further processed for histopathological analyses. The results showed that there were nucleus pulposus fragments, rather than a distinct border between the nucleus and annulus fibrosus. The central lamellae were distorted and delamination of the outer anterior layers was observed. Blood vessels emerged from the adjacent tissue, penetrated the annulus and branched into the residues of the nucleus. Nerve fibres accompanying the blood vessels could be recognized in the disc within the connective scar tissue. The epiphyseal cartilage plates in the vertebrae were hypertrophic in several areas and there was bone formation directed towards the centre of the vertebral body and the disc. Hypertrophic hyaline cartilage, newly formed bone and scar tissue filled the injury canal. A slight chronic inflammatory reaction was evident along vascular buds. The reactive changes dominated over the degenerated features in the operated disc. Physiological loading enhanced the infiltration of various tissue types characterizing immature cartilage formation. Prominent neovascularisation of the central parts of the disc is likely to be of key importance in turning the degenerative features of the remaining tissue into reactive healthy structures.

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Endometriosis-Associated Massive Ascites in an Asian Woman: A Case Report of a Rare Clinical Entity

Case Reports in Obstetrics and Gynecology ◽

10.1155/2020/8879643 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Nuntasiri Eamudomkarn ◽

Naratassapol Likitdee ◽

Pilaiwan Kleebkaow ◽

Chumnan Kietpeerakool

Keyword(s):

Broad Ligament ◽

Abdominal Distension ◽

Exploratory Laparotomy ◽

Final Diagnosis ◽

Clinical Entity ◽

Asian Woman ◽

Rare Clinical Entity ◽

Childbearing Age ◽

Massive Ascites ◽

History Of

Massive ascites as a presentation of endometriosis is a rare clinical entity that is most commonly seen in black nulliparous females. Herein, we describe a case of a 32-year-old multiparous Thai woman who presented with a two-year history of abdominal distension. Computerized tomography of the abdominopelvic region showed an infiltrative enhancing lesion involving the cul-de-sac and perirectal region with massive loculated ascites, suggesting carcinomatosis peritonei. Abdominal paracentesis was performed to yield fluid samples for evaluation, which revealed no malignant cells, and polymerase chain reaction (PCR) was negative for tuberculosis. The patient underwent exploratory laparotomy which revealed a large amount of serosanguinous ascites, thickened matted bowel loops, and necrotic debris covering the entire surface of the peritoneum and visceral organs. The surgical procedures included drainage of 6.5 liters of ascites, lysis adhesion, biopsy of the peritoneum, and right salpingo-oophorectomy. Histologic examination revealed benign endometrial glands with stroma at the peritoneum tissue and broad ligament. Other causes of ascites were excluded. The ascites responded to drainage and hormonal suppression. A final diagnosis of endometriosis was made based on these findings. Endometriosis should therefore be considered in differential diagnosis in women of childbearing age who present with ascites.

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