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malignant ascites

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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


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Malignant ascites This condition is generally associated with peritoneal metastases but other causes include hypoalbuminaemia, portal hypertension, hyperaldosteronism.
Stage IC Stage IA or IB with malignant ascites or capsule rupture or with tumor on the surface of one or both ovaries or with positive peritoneal washings.
The third patient remained pain free until the 11th month post cryosurgery at which time she developed malignant ascites.
 
 
 
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