Chhabra Puneet, Soni Sushant, Khurana Hunny
Department of Gastroenterology, Yashoda Superspeciality Hospital, Kaushambi, Ghaziabad, India.
Soni Diagnostics, New Delhi, India.
Perm J. 2019;23. doi: 10.7812/TPP/18-114. Epub 2019 Jun 24.
Ascites in patients with cardiac disease can be multifactorial. Serum ascitic albumin gradient (SAAG) helps in identifying the etiology of ascites. High SAAG ascites is related to hepatic or posthepatic causes. The causes of low SAAG ascites results include tuberculosis, peritoneal malignancy, or pancreatitis.
We report an unusual cause of low SAAG ascites in a 48-year-old woman with valvular heart disease. The patient presented with ascites, and cross-sectional imaging revealed a right iliac fossa mass with omental deposits. The patient was finally diagnosed as having pseudomyxoma peritonei on the basis of clinicoradiopathological features.
Pseudomyxoma peritonei is a rare cause of low SAAG ascites. It is characterized by the deposition of mucinous material on the peritoneal surfaces. The most common site of origin is the appendix, although it can arise from other intraabdominal organs as well. Excision of the tumor combined with intraperitoneal chemotherapy is the preferred modality of treatment.
心脏病患者的腹水可能是多因素导致的。血清腹水白蛋白梯度（SAAG）有助于确定腹水的病因。高SAAG腹水与肝脏或肝后性病因有关。低SAAG腹水的病因包括结核病、腹膜恶性肿瘤或胰腺炎。
我们报告了一名48岁患有瓣膜性心脏病的女性出现低SAAG腹水的不寻常病因。该患者出现腹水，横断面成像显示右髂窝有肿块并伴有网膜沉积物。根据临床放射病理特征，该患者最终被诊断为腹膜假黏液瘤。
腹膜假黏液瘤是低SAAG腹水的罕见病因。其特征是黏液物质沉积在腹膜表面。最常见的起源部位是阑尾，不过也可能起源于其他腹腔内器官。肿瘤切除联合腹腔内化疗是首选的治疗方式。
