Osaka Medical and Pharmaceutical University Hospital, Japan.
Intern Med. 2024 Jun 15;63(12):1703-1706. doi: 10.2169/internalmedicine.2716-23. Epub 2023 Nov 13.
A 53-year-old man presented with abdominal symptoms and a fever for 6 months and ascites and lower body edema for 2 months before visiting our clinic. Heart failure, renal failure, inferior vena cava or portal vein obstruction, cirrhosis, and malignancy were suspected, but none were present. We also suspected protein-leakage gastroenteropathy based on the elevated alpha-1 antitrypsin clearance (224 mL/day). Based on the double-balloon endoscopy findings, we diagnosed the patient with primary intestinal lymphangiectasia. Since the patient's ascites were not satisfactorily controlled medically, a Denver peritoneovenous shunt was placed. As a result, the ascites volume was successfully controlled over an extended period.
一位 53 岁男性因腹部症状和发热 6 个月，腹水和下肢水肿 2 个月就诊于我院。考虑心力衰竭、肾衰竭、下腔静脉或门静脉阻塞、肝硬化和恶性肿瘤，但均不明确。我们还根据升高的α-1 抗胰蛋白酶清除率（224 毫升/天）怀疑蛋白渗漏性胃肠病。根据双气囊内镜检查结果，我们诊断患者为原发性肠淋巴管扩张症。由于患者的腹水经药物治疗无法得到满意控制，我们为其进行了 Denver 腹膜静脉分流术。结果，腹水体积得到了成功控制，且持续时间较长。
