Chylous Ascites Should Suggest Constrictive Pericarditis Even in a Patient with Cirrhosis

Williams, AT; Rp, Schneider

doi:10.1097/00004836-199010000-00019

Cited by 9 publications

(4 citation statements)

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“…Even tough there are cases of heart diseases presenting as liver diseases [9-11], this is the first case of chylous ascites caused by heart failure, with no signs or symptoms of cardiac disorder. There are some cases associated with constrictive pericarditis [12-14] and with severe heart failure [15,16]; all these patients showed signs or symptoms manifesting cardiac involvement (pulmonary edema, jugular vein distension, etc.). There are two mechanisms probably involved: an increase in the abdominal lymph production and an ineffective development of collateral flow.…”

Section: Discussionmentioning

confidence: 99%

Chylous ascites as the main manifestation of left ventricular dysfunction: a case report

Ridruejo

Mandó

2005

BMC Gastroenterol

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Section: Discussionmentioning

confidence: 99%

Chylous ascites as the main manifestation of left ventricular dysfunction: a case report

Ridruejo

Mandó

2005

BMC Gastroenterol

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“…[6,7] Increase in the abdominal lymph production due to high venous pressure is probably responsible for few cases of CA associated with constrictive pericarditis [7][8][9][10] and severe heart failure. [11,12] Abdominal swelling is the most common symptom in CA. However, the features of the primary disease may dominate the clinical picture.…”

Section: Discussionmentioning

confidence: 99%

Chylous Ascites in HIV/TB Co-Infections: Case Report, Challenges of Management in a Resource-Poor Setting and Literature Review

Busari¹

2017

JMSCR

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Chylous ascites is an uncommon clinical condition characterized by extravasation of milky chyle into the peritoneal cavity usually as a result of either blockage of the lymphatics or leakage from inadvertent trauma during surgeries. This is a report of a case of chylous ascites in a 32-year old Nigerian with HIV/TB coinfections. The report also highlights the challenges associated with management of chylous ascites in a resource-poor setting. The patient was managed conservatively with diuretic therapy, salt and fluid restrictions and elevation of the lower limbs.Although, the ascites re-accumulated initially, it finally resolved and she was followed up for at least six months with no recurrence.

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“…However, protein-losing gastroenteropathy due to impaired lymphatic drainage from the small intestine can be observed, as well as chylous ascites. 1,9 Three mechanisms are possibly involved in the pathophysiology of lymphedema: elevated central venous pressure leading to alteration of the lymphatic drainage, thoracic duct lesion induced by radiotherapy, and increase of lymph production. In our case, we feel that constriction of right-heart cavities by fibrous pericardium led to increased central venous pressure.…”

Section: Discussionmentioning

confidence: 99%

Severe Lower Limbs Lymphedema Following Breast Carcinoma Treatment Revealing Radiation-Induced Constrictive Pericarditis

et al. 2005

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In patients treated for breast carcinoma, unilateral lymphedema of the upper limb is usual. However, to the authors' knowledge, lower limb lymphedema has never been reported as a complication of breast carcinoma therapy. They report here the first case of a radiation-induced constrictive pericarditis revealed by severe lower limbs lymphedema. A 60-year-old woman was treated for left breast carcinoma with quadrantectomy, axillary lymphadenectomy, and combined radio chemotherapy (60 grays). Three and a half years later she suffered from a diffuse and increasing lower limbs lymphedema, which became huge and disabling. Radiation-induced constrictive pericarditis was evidenced by right cardiac cavities catheterization. A dramatic improvement was rapidly obtained after pericardectomy. Histopathologic analysis of the pericardium did not reveal neoplastic cells. Radiation-induced constrictive pericarditis is usually responsible for lower limbs edema, but lymphedema is exceptional. This case highlights the need to search for a constrictive pericarditis also in the case of lower limbs lymphedema, particularly in a patient treated with mediastinal radiotherapy or combined radio chemotherapy.

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Chylous Ascites Should Suggest Constrictive Pericarditis Even in a Patient with Cirrhosis

Cited by 9 publications

References 0 publications

Chylous ascites as the main manifestation of left ventricular dysfunction: a case report

Chylous ascites as the main manifestation of left ventricular dysfunction: a case report

Chylous Ascites in HIV/TB Co-Infections: Case Report, Challenges of Management in a Resource-Poor Setting and Literature Review

Severe Lower Limbs Lymphedema Following Breast Carcinoma Treatment Revealing Radiation-Induced Constrictive Pericarditis

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