Idiopathic Neonatal Hemorrhagic Ascites: Conservative management is an option (original) (raw)
Related papers
Medicine Today, 2017
When foetal ascites is found alone (i.e., without other signs of hydrops), it may represent a separate problem requiring a different management strategy, leading to a different outcome. A 24-year-old primigravida was referred to our institution at 27 weeks of gestation with a diagnosis of isolated foetal ascites. No other pathology was detected on ultrasonography or a laboratory examination. The patient delivered a male infant weighing 3020 g at 38 weeks of gestation with Apgar scores of 7 and 9 at 1 and 5 minutes, respectively. The newborn was operated on by a paediatric surgery team with an indication of intrauterine extra-hepatic bile duct perforation in the first post-partum week, and was subsequently discharged from the hospital without any complications. Isolated foetal ascites is a rare and separate situation from foetal hydrops. The perinatal outcome for isolated ascites is much better than that for hydrops foetalis.
Neonatal Urinary Ascites: A Report of Three Cases
Case Reports in Nephrology, 2015
Urinary ascites in neonates is not a common condition. Three cases of urinary ascites are presented and each of them has a different aetiology. Neonates with urinary ascites usually present as clinical emergency, requiring resuscitation, ventilator support, and subsequent drainage of urine. The ultimate management depends on the site of extravasation and the underlying cause.
Case Report Neonatal Urinary Ascites: A Report of Three Cases
2020
Urinary ascites in neonates is not a common condition. Three cases of urinary ascites are presented and each of them has a different aetiology. Neonates with urinary ascites usually present as clinical emergency, requiring resuscitation, ventilator support, and subsequent drainage of urine. The ultimate management depends on the site of extravasation and the underlying cause.
Umbilical hernia in a patient with ascites Clinical case
American Journal of Medical and Clinical Research & Reviews, 2023
INTRODUCTION. Since 1808, umbilical hernias were registered based on existing data, in such a way that 4716 scientific articles were registered in the last two centuries. About 6 to 14% of all abdominal wall hernias in adults are umbilical hernias with a prevalence of 2%. CLINICAL CASE. A 47-year-old male came to the emergency room presenting with a giant umbilical hernia, liver cirrhosis and increased abdominal girth, fluid retention (ascites) to perform paracentesis of approximately 5 Liters, presenting confusion, asterixis, dyslalia, aphasia, upon admission. no coordination of walking. On physical examination, she was found to be hemodynamically unstable with the presence of ascitic fluid leakage through an ulcer caused by tension in the umbilical region; feverish peaks, for which reason a liquid sample was taken by puncture in the left iliac fossa, yellow in color and cloudy in appearance with glucose 106 mg/dL, LDH 239 mg/ml, presence of Hb (+++), and leukocytosis. He was evaluated for general surgery. Where a non-reducible incarcerated umbilical hernia was observed, it was decided to treat the complicated hernia, partial omentectomy plus ventral plasty with the Rives-Stoppa technique plus omphaloplasty with Drenovac-type closed drainage was performed without complications. DISCUSSION. Cirrhotic patients who do not respond to medical treatments for ascites will require treatment such as serial therapeutic paracentesis. Large volume paracentesis (LVP), defined as the removal of more than 5 L of ascitic fluid, is an effective therapy for patients with tense ascites.
Diagnosis, etiology, and outcome of fetal ascites in a South African hospital
International Journal of Gynecology & Obstetrics, 2011
To analyze the etiology and outcome of fetal ascites in a hospital in a low-resource country. Method: Data were reviewed for patients with fetal ascites who attended Groote Schuur Hospital, Cape Town, South Africa, from 1 January, 2006, to 31 December, 2009. Results: There were 50 cases of fetal ascites. Prenatal investigations included detailed ultrasonography, Doppler studies, TORCH screening and chromosome analysis if amniocentesis was accepted by the patient. The underlying cause was diagnosed prenatally for 41 (82%) cases. The following etiologies were documented: secondary to a genetic cause (n = 10); structural fetal abnormality (n = 20); congenital syphilis (n = 4) or other infection (n = 3); fetal environment (n = 3); placenta (n = 3); and unknown origin (n = 7). The perinatal mortality was 72%. Factors predicting a poor prognosis included multiple abnormalities (100% fetal loss), cardiac anomalies (91% loss), hydrops fetalis (80% loss), and infection (71% loss). Ascites of unknown origin and ascites secondary to renal causes had the best prognosis (perinatal loss of 17% and 25%, respectively). Conclusion: The cause, and therefore the prognosis, was identified in 82% of cases of fetal ascites. The prognosis for prenatally diagnosed ascites was poor; however, a few patients did well, which has important implications for genetic counseling.
Urinary ascites in infancy: varied etiologies
Pediatric Surgery International, 2003
Three cases of urinary ascites are presented, each with a different underlying aetiology. The age and modes of presentation also varied and management strategies were accordingly tailored to each patient's clinical requirements. All 3 patients survived and subsequently were discharged with good renal function. Although a rare condition, infants with urinary ascites can present as clinical emergencies in need of prompt resuscitation with subsequent drainage of the urine and decompression of the urinary tract. The ultimate management regime will vary and depend upon site of urinary extravasation and underlying aetiology.
Isolated Fetal Ascites Secondary to Persistent Urogenital Sinus
Obstetrics and Gynecology International, 2009
Objective. To present a case of isolated ascites secondary due to urogenital abnormalities (urogenital sinus) without any other prenatal ultrasound marker. Method. A 36-year-old woman with prenatal isolated ascites delivered a female baby, weighing 2.285 g; ascites was drained at birth and the baby underwent several episodes of urinary retention prior to undergoing X-ray investigations. Results. A voiding cystourethrogram revealed a short urogenital sinus: a vesicostomy was performed. A vaginoscopy revealed double vagina with a large posterior vagina. A posterior sagittal anorectal pull-through with genitoplasty was performed at 2 years old with 1-year follow-up. Conclusions. Though rare, a urogenital abnormality is to be suspected in fetal ascites cases with negative viral tests and no cardiac anomalies. The most common ultrasound marker of such abnormalities (fluid filled cavity) may be missing because of complete drainage of urine through the tubes into peritoneum.
Prenatal diagnosis, 2015
The aim of this study is to analyze the contribution of biochemistry and cytology of fetal ascites fluid to the etiological diagnosis of ascites after ultrasonographic scan, maternal blood sampling, and fetal karyotyping. This is a retrospective study of 100 consecutive cases of nonimmune fetal ascites in which ascites fluid was sampled. All women underwent referral ultrasound scan and fetal karyotyping. All cases of fetal ascites were studied by biochemistry (total protein, β2 -microglobulin, IgM, gamma-glutamyl transpeptidase, aspartate aminotransferase, aminopeptidase M, and intestinal isoform of alkaline phosphatase) and cytology (lymphocyte count and vacuolated cells). The etiology of ascites was diagnosed at ultrasound scan in only 50% of cases. We observed significantly (P < 0.001) low levels of total protein in ascites of urinary origin, high levels of digestive enzymes in ascites of digestive origin, and high β2 -microglobulin in infectious ascites. Vacuolated cells were...