malignant ascites

malignant ascites

Excess peritoneal fluid evoked by malignancy, which causes subdiaphragmatic lymphatic obstruction (e.g., of the thoracic duct) and increased intraperitoneal fluid production.

Clinical findings
Abdominal distension, weight gain, indigestion, dyspnea, orthopnea, tachypnoea, intestinal obstruction with nausea, vomiting.
 
Aetiology
Ovarian, breast, gastric, pancreatic, hepatic, and colorectal carcinomas, lymphoma, mesothelioma.
 
DiffDx
Tuberculosis, congestive heart failure, nephrotic syndrome, hepatic disease, bacterial peritonitis, malnutrition (due to hypoalbuminemia).
 
Management
Drainage of fluid, intraperitoneal chemotherapy, antibiotics, radioactive colloids, biological response modifiers (e.g., IL-2, alpha-IFN, external-beam radiation therapy), and surgical placement of LeVeen or Denver shunts.
 
Prognosis
Poor.

Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

malignant ascites

Excess peritoneal fluid evoked by malignancy, which causes subdiaphragmatic lymphatic obstruction–eg, of the thoracic duct and ↑ intraperitoneal fluid production Etiology Ovarian, breast, gastric, pancreatic, hepatic, colorectal CA, lymphoma, mesothelioma Clinical Abdominal distension, weight gain, indigestion, dyspnea, orthopnea, tachypnea, intestinal obstruction with N&V Imaging Ground glass appearance, central positioning of small bowel loops, and obscured psoas sign on plain abdominal films; MA is confirmed with ultrasonography, CT, and MRI DiffDx TB, CHF, nephrotic syndrome, hepatic disease, bacterial peritonitis, malnutrition–due to hypoalbuminemia Management Drainage of fluid; intraperitoneal chemotherapy, antibiotics, radioactive colloids, biological response modifiers–eg, IL-2, α-IFN, external-beam RT, and surgical placement of LeVeen or Denver shunts Prognosis Poor

McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.