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一例肝硬化合并乳糜性腹水及腹部淋巴系统多发囊性扩张病例。

A case of liver cirrhosis with chylous ascites and multiple cystic dilatation of the abdominal lymphatic system.

作者信息

Watanabe M, Taketa K, Yonei J, Kubota M, Nagashima H, Akamutsu K, Awai M

出版信息

Hepatogastroenterology. 1980 Oct;27(5):394-400.

PMID:7203372
Abstract

A 51-year-old male suffering from abdominal distension and diagnosed by laparoscopic and histological examination as a liver cirrhosis patient, had a chylous ascites with a negative Gordon test. The content of chylomicron in ascites decreased by restriction of dietary fat, although the ascites retention was resistant to salt restriction, diuretics and intravenous re-infusion of ascites. Lymphangiography revealed dysplasia of the retroperitoneal lymphatic system and dilatation of the thoracic duct. Main autopsy findings were liver cirrhosis (post-necrotic type) without malignancy and marked cystic dilatations of the lymphatic duct. The lymph congestion in the intestine was more remarkable in the subserosal space and the leakage of the chyle into the abdominal cavity was also proved by histological examination.

摘要

一名51岁男性,因腹胀就诊,经腹腔镜及组织学检查诊断为肝硬化患者,伴有乳糜性腹水,戈登试验阴性。尽管腹水潴留对限盐、利尿剂及腹水静脉回输治疗均有抵抗,但通过限制饮食脂肪,腹水中乳糜微粒含量有所下降。淋巴管造影显示腹膜后淋巴系统发育异常及胸导管扩张。尸检主要发现为无恶性肿瘤的肝硬化(坏死后型)及淋巴管明显的囊性扩张。组织学检查也证实,肠壁浆膜下间隙淋巴充血更为显著,且有乳糜漏入腹腔。

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