Management of ascites in children

Lane, Erin R.; Hsu, Evelyn; Murray, Karen F.

doi:10.1586/17474124.2015.1083419

Cited by 33 publications

(69 citation statements)

References 55 publications

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“…Abdominal ultrasound is also helpful to evaluate liver and biliary anatomy and the portal system, as well as estimating the volume of the ascitic fluid. However, when the underlying etiology is unclear a diagnostic paracentesis could be necessary [5]. The patient herein reported was initially referred for IBD.…”

Section: Discussionmentioning

confidence: 99%

“…Budd-Chiari syndrome), infections (e.g. CMV, EBV, tuberculosis), inflammatory bowel disease (IBD), malignancies, omental cyst [5]. Noncirrhotic ascites can develop as a consequence of secretion of proteinaceous material (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…compromised ventilation, infections, gastrointestinal hemorrhage, renal failure). Non-cirrhotic ascites constitutes, however, a vast category of causes with a high degree of overlapping sign and symptoms often leading to delayed diagnosis and unnecessary surgery [5].…”

Section: Introductionmentioning

confidence: 99%

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Peritoneal tuberculosis mimicking carcinomatous ascites in a child living in a low prevalence country: a case report

Rossi¹,

Melone²,

Turco³

et al. 2020

Ital J Pediatr

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Background: Ascites can develop as a consequence of a number of diseases in childhood. Despite chronic liver disease is the most common cause, several conditions can lead to ascites also in the absence of liver dysfunction. As non-cirrhotic ascites shows a high degree of overlapping sign and symptoms it is still a challenge for physicians. Case presentation: A 8-year-old Caucasian girl was referred for fever, vomit and diarrhea occurred over the past few weeks. Physical examination showed timpanitic distension of the abdomen with marked tenderness and increased abdominal wall rigidity. Abdominal imaging showed diffuse ascites and thickened omentum and bowel wall. Blood tests showed increased C-reactive protein levels and decreased lymphocyte count. Specific treatment for inflammatory bowel disease was started. Persisting of ascites required additional investigations. Positive tuberculin skin test and Interferon Gamma release assay (IGRA) as well as increased Ca125 serum concentrations were found. Computed tomography scan showed mediastinal and mesenteric adenopathies and diffuse smooth thickening of the omentum with significant enhancement (omental cake-like). Ascitic fluid analysis revealed high leucocytes and protein levels. Presumptive diagnosis of peritoneal tuberculosis (PTB) was made. Antituberculous treatment resulted in the resolution of ascites and normalization of lymphocyte count and Ca125 serum concentrations. Conclusions: PTB is still possible in low-prevalence countries. As it is a great mimicker of other abdominal pathology whose treatment might worsen tuberculosis progression, clinical suspicion and adequate screening are required to avoid unnecessary interventions and delayed treatment. Ca125 is a non-specific marker of peritoneal inflammation but it might be helpful in monitoring the treatment response.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Peritoneal tuberculosis mimicking carcinomatous ascites in a child living in a low prevalence country: a case report

Rossi¹,

Melone²,

Turco³

et al. 2020

Ital J Pediatr

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“…5,8,31 Albumin infusion is also recommended for pediatric patients with a blood albumin level ≤ 2.5 g/dL to promote extravascular water reabsorption, associated with loop diuretics to produce more diuresis. 2,87 It has been observed that albumin infusion and water restriction correct HH in children, and other authors have proposed this treatment for adults, 88 but there are no good-quality studies to support this recommendation. 8,89 Albumin infusion alone or together with vasopressors may also be useful for the management of HH.…”

Section: Therapeutic Options Albumin Prescriptionmentioning

confidence: 99%

Management of cirrhotic ascites in children. Review and recommendations. Part 2: Electrolyte disturbances, nonelectrolyte disturbances, therapeutic options

et al. 2017

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Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of a pediatric patient with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to diagnostic and therapeutic aspects, and preventive care.

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“…5,8,31 La infusión de albúmina también se recomienda en pacientes pediátricos con albuminemias ≤ 2,5 g/dL para promover la reabsorción extravascular de agua, asociada a diuréticos de asa para producir mayor diuresis. 2,87 Hemos observado que la infusión de albúmina y la restricción hídrica corrigen la HH en niños, y otros autores proponen este tratamiento en adultos, 88 pero no existen estudios de buena calidad que avalen su recomendación. 8,89 La infusión sola o asociada a drogas vasoconstrictoras también podría ser útil para tratar la HH.…”

Section: Opciones Terapéuticas Prescripción De Albúminaunclassified

Manejo de la ascitis secundaria a cirrosis en el paciente pediátrico. Revisión y recomendaciones. Parte 2: Complicaciones electrolíticas, complicaciones no electrolíticas, opciones terapéuticas

et al. 2017

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Management of ascites in children

Cited by 33 publications

References 55 publications

Peritoneal tuberculosis mimicking carcinomatous ascites in a child living in a low prevalence country: a case report

Peritoneal tuberculosis mimicking carcinomatous ascites in a child living in a low prevalence country: a case report

Management of cirrhotic ascites in children. Review and recommendations. Part 2: Electrolyte disturbances, nonelectrolyte disturbances, therapeutic options

Manejo de la ascitis secundaria a cirrosis en el paciente pediátrico. Revisión y recomendaciones. Parte 2: Complicaciones electrolíticas, complicaciones no electrolíticas, opciones terapéuticas

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