以乳糜性腹水为主要表现的左心室功能障碍：一例报告
Chylous ascites as the main manifestation of left ventricular dysfunction: a case report.
作者信息
Ridruejo Ezequiel, Mandó Oscar G
机构信息
Hepatology Section, Department of Internal Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, Buenos Aires, Argentina.
出版信息
BMC Gastroenterol. 2005 Aug 3;5:25. doi: 10.1186/1471-230X-5-25.
BACKGROUND
Ascites is one of the most common complications of liver diseases, even though in 15% of the cases it is related to extrahepatic diseases; 3% are of cardiac nature and they appear associated with signs and symptoms of heart failure.
CASE PRESENTATION
A 70 year old man was admitted with more than one year history of abdominal distension and a weight gain of 10 kilograms. He is asymptomatic and walks 2000-3000 meters a day without angor or dyspnea. The physical examination shows moderate abdominal distension, with no hepatosplenomegaly or edema, and there is mild jugular vein distension. The studies performed (complete laboratory work up, paracentesis, liver biopsy, echocardiogram, intrahepatic pressure measurements, etc.) showed a chylous ascites related to portal hypertension, and left ventricular dysfunction was the only probable cause found.
CONCLUSION
Asymptomatic heart dysfunction can mimic liver disease and should be kept in mind as a cause of chylous ascites.
背景
腹水是肝脏疾病最常见的并发症之一，尽管15%的病例与肝外疾病有关；3%为心脏源性，且常伴有心力衰竭的体征和症状。
病例介绍
一名70岁男性因腹胀病史超过一年且体重增加10千克入院。他无症状，每天步行2000 - 3000米，无胸痛或呼吸困难。体格检查显示中度腹胀，无肝脾肿大或水肿，有轻度颈静脉扩张。所进行的检查（完整的实验室检查、腹腔穿刺、肝活检、超声心动图、肝内压力测量等）显示为与门静脉高压相关的乳糜性腹水，且仅发现左心室功能障碍是可能病因。
结论
无症状性心脏功能障碍可类似肝脏疾病，应作为乳糜性腹水的病因加以考虑。
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