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腹膜感染作为腹水的一个病因:不容忽视的诊断。

Peritoneal Infection as a Cause of Ascites: A Diagnosis Not to Be Missed.

作者信息

Barros Luísa Leite, da Silva Jessica Calheiros, Dantas Anna Carolina Batista, Martins Leandro Aurelio Liporoni, Klajner Sidney, Farias Alberto Queiroz

机构信息

Departamento de Gastroenterologia, Hospital Das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

Hospital Israelita Albert Einstein, São Paulo, Brazil.

出版信息

Case Rep Gastroenterol. 2021 Oct 11;15(3):898-903. doi: 10.1159/000519706. eCollection 2021 Sep-Dec.

Abstract

Ascites is a common complication of several conditions, but it is rare in cases of infection. We report a 36-year-old patient presenting with abdominal swelling for a week prior to hospitalization. An extensive workup excluded liver or heart disease and malignancy. A computed tomography scan demonstrated massive ascites and severe thickening of peritoneal reflections. Laboratory tests showed low serum-ascites albumin gradient, high total protein, and low adenosine. Diagnostic laparoscopy revealed inflammatory signs of both fallopian tubes. The histopathological results from peritoneal biopsy were consistent with lymphoid proliferation with reactive lymphoplasmacytic infiltrate. A gynecological investigation showed a positive DNA for in the cervical swab. After treatment with doxycycline, there was a complete resolution of ascites.

摘要

腹水是多种病症的常见并发症,但在感染病例中较为罕见。我们报告一例36岁患者,住院前一周出现腹部肿胀。全面检查排除了肝脏、心脏疾病及恶性肿瘤。计算机断层扫描显示大量腹水及腹膜反折严重增厚。实验室检查显示血清腹水白蛋白梯度低、总蛋白高及腺苷低。诊断性腹腔镜检查显示双侧输卵管有炎症迹象。腹膜活检的组织病理学结果与伴有反应性淋巴浆细胞浸润的淋巴样增生一致。妇科检查显示宫颈拭子DNA检测呈阳性。经强力霉素治疗后,腹水完全消退。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2087/8543310/441a360313ec/crg-0015-0898-g01.jpg

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