间断乳糜性腹水1例
|
摘要
<正>患者,男,60岁,因间断腹胀1年余,加重5 d于2018年4月24日入院。既往肝硬化病史1年余,患者自述因腹胀间断于外院住院治疗10次,每次治疗期间均行腹腔穿刺置管引流治疗并送检腹水常规、生化检查,提示渗出液、腹水脱落细胞均未见恶性细胞。查体:P 70 次/min,BP 100/70 mmHg。全身皮肤黏膜及巩膜无黄染,无肝掌、蜘蛛痣。心肺未见异常。腹部膨隆,绕脐腹围105 cm,最大腹围112 cm,腹壁静脉显露,全腹无明显压痛、反跳
引文
[1] Lizaola B, Bonder A, Trivedi HD, et al. Review article: the diagnostic approach and current management of chylous ascites[J]. Alimentary Pharmacology & Therapeutics, 2017,46(9):815-824. DOI: 10.1111/apt.14284.
[2] Al-Busafi SA, Peter G, Marc D, et al. Chylous ascites: evaluation and management[J]. Isrn Hepatology, 2014,2014:240473. DOI: 10.1155/2014/240473.
[3] Steinemann DC, Dindo D, Clavien PA, et al. Atraumatic chylous ascites: systematic review on symptoms and causes[J]. Journal of the American College of Surgeons, 2011, 212(5):899-905.e1-4. DOI: 10.1016/j.jamcollsurg.2011.01.010.
[4] Bhardwaj R, Vaziri H, Gautam A, et al. Chylous ascites: a review of pathogenesis, diagnosis and treatment[J]. Journal of Clinical & Translational Hepatology, 2018, 6(1):105-113. DOI: 10.14218/JCTH.2017.00035.
[5] Sriram K, Meguid RA, Meguid MM. Nutritional support in adults with chyle leaks[J]. Nutrition, 2016, 32(2):281-286. DOI: 10.1016/j.nut.2015.08.002.
[6] Lizaola B, Bonder A, Trivedi HD, et al. Review article: the diagnostic approach and current management of chylous ascites [J]. Aliment Pharmacol Ther,2017 ,46(9):816-824. DOI: 10.1111/apt.14284.
[7] Nadolski GJ, Chauhan NR, Itkin M. Lymphangiography and lymphatic embolization for the treatment of refractory chylous ascites[J]. Cardiovascular & Interventional Radiology, 2018, 41(3):415-423. DOI: 10.1007/s00270-017-1856-1.
[8] McConnell M, Iwakiri Y. Biology of portal hypertension[J]. Hepatol Int. 2018,12(1):11-23.DOI: 10.1007/s12072-017-9826-x.
[9] Iwazu Y, Komori S, Nagata D. Change of Chylous Ascites During Low-Density Lipoprotein Apheresis in a Patient With Idiopathic Nephrotic Syndrome[J]. Therapeutic Apheresis & Dialysis, 2015, 19(1):97-98. DOI: 10.1111/1744-9987.12225.
[2] Al-Busafi SA, Peter G, Marc D, et al. Chylous ascites: evaluation and management[J]. Isrn Hepatology, 2014,2014:240473. DOI: 10.1155/2014/240473.
[3] Steinemann DC, Dindo D, Clavien PA, et al. Atraumatic chylous ascites: systematic review on symptoms and causes[J]. Journal of the American College of Surgeons, 2011, 212(5):899-905.e1-4. DOI: 10.1016/j.jamcollsurg.2011.01.010.
[4] Bhardwaj R, Vaziri H, Gautam A, et al. Chylous ascites: a review of pathogenesis, diagnosis and treatment[J]. Journal of Clinical & Translational Hepatology, 2018, 6(1):105-113. DOI: 10.14218/JCTH.2017.00035.
[5] Sriram K, Meguid RA, Meguid MM. Nutritional support in adults with chyle leaks[J]. Nutrition, 2016, 32(2):281-286. DOI: 10.1016/j.nut.2015.08.002.
[6] Lizaola B, Bonder A, Trivedi HD, et al. Review article: the diagnostic approach and current management of chylous ascites [J]. Aliment Pharmacol Ther,2017 ,46(9):816-824. DOI: 10.1111/apt.14284.
[7] Nadolski GJ, Chauhan NR, Itkin M. Lymphangiography and lymphatic embolization for the treatment of refractory chylous ascites[J]. Cardiovascular & Interventional Radiology, 2018, 41(3):415-423. DOI: 10.1007/s00270-017-1856-1.
[8] McConnell M, Iwakiri Y. Biology of portal hypertension[J]. Hepatol Int. 2018,12(1):11-23.DOI: 10.1007/s12072-017-9826-x.
[9] Iwazu Y, Komori S, Nagata D. Change of Chylous Ascites During Low-Density Lipoprotein Apheresis in a Patient With Idiopathic Nephrotic Syndrome[J]. Therapeutic Apheresis & Dialysis, 2015, 19(1):97-98. DOI: 10.1111/1744-9987.12225.