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当腹水隐藏更多问题时:一种不寻常表现中的诊断困境

When Ascites Hides More: A Diagnostic Dilemma in an Unusual Presentation.

作者信息

Gupta Abhinav, Mehta Varun, Goyal Manjeet K, Khubber Manisha, Gupta Yogesh K

机构信息

Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, IND.

Gastroenterology and Hepatology, Dayanand Medical College and Hospital, Ludhiana, IND.

出版信息

Cureus. 2025 Jan 1;17(1):e76721. doi: 10.7759/cureus.76721. eCollection 2025 Jan.

DOI:10.7759/cureus.76721
PMID:39897253
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11785460/
Abstract

Eosinophilic ascites, a rare manifestation of eosinophilic gastroenteritis, is characterized by eosinophilic infiltration in the gastrointestinal tract and ascitic fluid. In this case, a 60-year-old male presented with abdominal pain and vomiting, with diagnostic challenges due to non-specific symptoms. The diagnosis was made based on history and eosinophil-rich ascites. Treatment with corticosteroids resulted in symptom improvement. This case emphasizes the importance of early recognition and prompt treatment to avoid unnecessary surgical intervention in patients with unexplained ascites.

摘要

嗜酸性腹水是嗜酸性胃肠炎的一种罕见表现,其特征为胃肠道和腹水中有嗜酸性粒细胞浸润。在该病例中,一名60岁男性出现腹痛和呕吐症状,因其症状不具特异性而面临诊断挑战。诊断基于病史和富含嗜酸性粒细胞的腹水。使用皮质类固醇治疗后症状得到改善。该病例强调了早期识别和及时治疗对于避免对不明原因腹水患者进行不必要手术干预的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ffe/11785460/4b44512ef5b7/cureus-0017-00000076721-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ffe/11785460/e6fa58c08048/cureus-0017-00000076721-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ffe/11785460/f9418d7b53fc/cureus-0017-00000076721-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ffe/11785460/3181ece42f96/cureus-0017-00000076721-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ffe/11785460/4b44512ef5b7/cureus-0017-00000076721-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ffe/11785460/e6fa58c08048/cureus-0017-00000076721-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ffe/11785460/f9418d7b53fc/cureus-0017-00000076721-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ffe/11785460/3181ece42f96/cureus-0017-00000076721-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ffe/11785460/4b44512ef5b7/cureus-0017-00000076721-i04.jpg

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本文引用的文献

1
Prospective study of an amino acid-based elemental diet in an eosinophilic gastritis and gastroenteritis nutrition trial.一种氨基酸型要素膳用于嗜酸细胞性胃炎和胃肠炎营养试验的前瞻性研究。
J Allergy Clin Immunol. 2023 Sep;152(3):676-688. doi: 10.1016/j.jaci.2023.05.024. Epub 2023 Jul 18.
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Anti-Siglec-8 Antibody for Eosinophilic Gastritis and Duodenitis.抗 Siglec-8 抗体治疗嗜酸性胃炎和十二指肠炎。
N Engl J Med. 2020 Oct 22;383(17):1624-1634. doi: 10.1056/NEJMoa2012047.
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Increasing Rates of Diagnosis, Substantial Co-Occurrence, and Variable Treatment Patterns of Eosinophilic Gastritis, Gastroenteritis, and Colitis Based on 10-Year Data Across a Multicenter Consortium.
基于多中心联盟 10 年数据,嗜酸细胞性胃炎、胃肠炎和结肠炎的诊断率不断上升,合并率高,治疗模式多样。
Am J Gastroenterol. 2019 Jun;114(6):984-994. doi: 10.14309/ajg.0000000000000228.
4
Eosinophilic Gastroenteritis: Clinical Manifestation, Natural Course, and Evaluation of Treatment with Corticosteroids and Vedolizumab.嗜酸性粒细胞性胃肠炎:临床表现、自然病程,以及皮质类固醇和维得利珠单抗治疗的评估。
Dig Dis Sci. 2019 Aug;64(8):2231-2241. doi: 10.1007/s10620-019-05617-3. Epub 2019 Apr 13.
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Benralizumab for -Negative Hypereosinophilic Syndrome.贝那利珠单抗治疗 - 阴性嗜酸性粒细胞综合征。
N Engl J Med. 2019 Apr 4;380(14):1336-1346. doi: 10.1056/NEJMoa1812185.
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Eosinophilic enteritis.嗜酸性粒细胞性肠炎
Dig Dis. 2015;33(2):183-189. doi: 10.1159/000369540. Epub 2015 Apr 22.
7
Cramping pain and eosinophilic ascites: what is the diagnosis?痉挛性疼痛与嗜酸性腹水:诊断结果是什么?
Gastroenterology. 2013 Jun;144(7):1353, 1577. doi: 10.1053/j.gastro.2013.01.008. Epub 2013 Apr 25.
8
Eosinophilic gastroenteritis--a diagnostic enigma.嗜酸性胃肠炎——一个诊断难题。
BMJ Case Rep. 2012 Aug 13;2012:bcr1220115436. doi: 10.1136/bcr.12.2011.5436.
9
Eosinophilic gastroenteritis: clinical manifestations and morphological characteristics, a retrospective study of 42 patients.嗜酸性粒细胞性胃肠炎:临床表现及形态学特征,42例患者的回顾性研究
Scand J Gastroenterol. 2011 Sep;46(9):1074-80. doi: 10.3109/00365521.2011.579998. Epub 2011 May 30.
10
A rare cause of ascites.腹水的罕见病因。
Gastroenterology. 2011 Apr;140(4):1149, 1364. doi: 10.1053/j.gastro.2010.05.095. Epub 2011 Feb 23.