Pancreatobiliary Reflux Resulting in Pancreatic Ascites and Choleperitoneum after Gallbladder Perforation
| Autor: | Monica Leutner, Elena Scaglia, Mario Pirisi, Stefano Fangazio, Michela Emma Burlone, Rachele Rapetti |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Pancreatic pseudocyst medicine.medical_treatment Peritonitis Gastroenterology Gallbladder perforation Published: November 2008 Hepatorenal syndrome Internal medicine Ascites Cholecystitis Medicine lcsh:RC799-869 business.industry Gallbladder Peritoneal fluid medicine.disease medicine.anatomical_structure Pancreatitis acute necrotizing Cholecystectomy lcsh:Diseases of the digestive system. Gastroenterology medicine.symptom business |
| Zdroj: | Case Reports in Gastroenterology, Vol 2, Iss 3, Pp 433-438 (2008) Case Reports in Gastroenterology |
| ISSN: | 1662-0631 |
| Popis: | A 65-year-old man with chronic hepatitis C and no history of alcohol abuse was admitted to our liver unit for the recent development of massive ascites and presumed hepatorenal syndrome. In the preceding two weeks, he had received medical treatment for acute pancreatitis and cholecystitis. Abdominal paracentesis demonstrated a cloudy, orange peritoneal fluid, with total protein concentration 3.6 g/dl, serum-ascites albumin gradient 1.0 g/dl, and ratios of ascites-serum bilirubin and amylase approximately 8:1. Diagnostic imaging demonstrated no pancreatic pseudocysts. Ten days later, at laparotomy, acalculous perforation of the gallbladder was identified. After cholecystectomy, amylase concentration in the ascitic fluid dropped within a few days to 40% of serum values; ascites disappeared within a few weeks. We conclude that in the presence of a perforated gallbladder, pancreatobiliary reflux was responsible for this unusual combination of choleperitoneum and pancreatic ascites, which we propose to call pancreatobiliary ascites. |
| Databáze: | OpenAIRE |
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