PubMed · 6823939
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F W Leung. 1983. Hemodialysis, ascites and thyroid function.. https://pubmed.ncbi.nlm.nih.gov/6823939/
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In a 51-year-old woman with bilateral Brenner tumours of the ovaries and with intermittent hydrothorax and ascites, Meigs' syndrome was diagnosed. The serum CA 125 level was 620 U/ml (normal: 5-35). Bilateral ovariectomy, hysterectomy and omentectomy were carried out. The ovaries were not enlarged. Postoperatively, the pleural effusion and ascites resolved and the CA 125 level decreased to 8.4 U/ml. The pathogenesis of hydrothorax probably involves passage through the diaphragm, and the CA 125 may be produced by the peritoneal lining or by the Brenner tumours.
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Tense, nonchylous ascites following a Whipple procedure has not been reported to date. We describe the course of such a patient successfully treated by a peritoneovenous shunt. A 49-year-old male developed tense ascites following pancreaticoduodenectomy. Despite conservative measures, abdominal distension developed to the point of dyspnea and orthopnea for over a six-month period. Because the physicochemical characteristic of the ascitic fluid was consistent with that of hepatic lymph, ascites was considered due to injury to the lymphatics around the porta hepatis. A peritoneovenous shunt was established for the treatment of ascites and was removed when the ascites had resolved at nine months after shunting. Our experience suggests that, in case conservative measures fail in the control of ascites, either direct repair of the lymphatic leak by laparotomy or the temporary use of peritoneovenous shunting may be considered.