Heureux F, Frankart L, Marchandise B, Buche M, Martinet J P, Donckier J
Service de Médecine Interne Générale et Endocrinologie, Cliniques Universitaires UCL de Mont-Godinne, 5530 YVOIR, Belgique.
Acta Clin Belg. 1997;52(3):176-81. doi: 10.1080/17843286.1997.11718570.
The authors report the cases of two patients suffering from ascites attributed for several years to a non pericarditic aetiology. The first patient presented with a diagnosis of right cardiac failure secondary to a right myocardial infarction. Cardiac catheterisation, magnetic resonance imaging and transoesophageal echocardiogram allowed to establish the diagnosis. In the second case, ascites was attributed to cirrhosis. Presence of pericardial calcifications, visible on a chest X-Ray led to suspect constrictive pericarditis. In both cases, ascites contained a high protein level. A pericardectomy allowed a favourable outcome in both cases. Thus, a diagnosis of constrictive pericarditis must be evoked in face of ascites of unclear origin and a normal cardiac size.
作者报告了两例腹水患者的病例,多年来腹水一直被归因于非心包炎病因。第一例患者被诊断为右心肌梗死继发右心衰竭。心脏导管检查、磁共振成像和经食管超声心动图得以确诊。第二例中,腹水归因于肝硬化。胸部X线显示心包钙化,这使人怀疑是缩窄性心包炎。两例患者腹水中蛋白质水平均较高。两例患者均通过心包切除术获得了良好疗效。因此,面对不明原因且心脏大小正常的腹水时,必须考虑缩窄性心包炎的诊断。