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Search on : chylous and ascites [Words]
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[PMID]: 29524461
[Au] Autor:Srinivasa RN; Chick JFB; Gemmete JJ; Hage AN; Srinivasa RN
[Ad] Address:Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health Systems, 1500 East Medical Center Drivem Ann Arbor, MI 48109.
[Ti] Title:Endolymphatic Interventions for the Treatment of Chylothorax and Chylous Ascites in Neonates: Technical and Clinical Success and Complications.
[So] Source:Ann Vasc Surg;, 2018 Mar 07.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: To report the technical and clinical success of performing minimally invasive endolymphatic embolization in neonates presenting with a chylothorax or chylous ascites. MATERIALS AND METHODS: 3 neonates, 2 males and 1 female, with a mean age of 28 days (range: 19-39 days) presented with a chylothorax (2) or chylous ascites (1) which was refractory to conservative management. All 3 patients (1 previously reported) underwent intranodal lymphangiography followed by thoracic duct embolization with 1 patient undergoing additional sclerosis of the retroperitoneal abdominal lymphatics. RESULTS: Lymphangiography, thoracic duct embolization, and sclerosis of the retroperitoneal abdominal lymphatics was technically successful. The chylothorax resolved in both patients. Persistent chylous ascites was noted after treatment that resolved after surgical placement of a vicryl mesh and fibrin sealant. 1 major complication occurred with non-target embolization of glue into the lungs requiring embolectomy. CONCLUSION: Thoracic duct and retroperitoneal abdominal lymphatic embolization can be performed in neonates. Resolution of chylothorax was seen in two patients (one previously reported) following embolization, while 1 patient with chylous ascites required surgical management after endolymphatic intervention.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 1412 MEDLINE  
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[PMID]: 29519170
[Au] Autor:Behera SK; Das S; Xavier AS; Selvarajan S
[Ad] Address:a Department of Clinical Pharmacology , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Puducherry , India.
[Ti] Title:DRESS syndrome: a detailed insight.
[So] Source:Hosp Pract (1995);, 2018 Mar 08.
[Is] ISSN:2154-8331
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a serious and potentially fatal adverse effect to therapeutic medications. The incidence of this condition varies among different ethnicities because of the difference in the genetic makeup. Though fever, rash and eosinophilia are essential features for the diagnosis of this syndrome, these vary from patient to patient along with the involvement of various organs such as liver, kidney, lungs, pancreas, etc. Some of the atypical features are dysphagia, agranulocytosis, and chylous ascites. Phenytoin, phenobarbitone, carbamazepine, and allopurinol are the most common drugs responsible for developing this syndrome, although the list is fairly long. Among the criteria used for the diagnosis of DRESS syndrome, European Registry of Severe Cutaneous Adverse Reactions to Drugs and Collection of Biological Samples (RegiSCAR) criteria is the most commonly used one. The management of this syndrome involves early removal of the causative agent and treatment with anti-histamines and emollients in the mild form, corticosteroids in the moderate form and plasmapheresis in the severe form along with other alternatives drugs. Healthcare professionals should be more vigilant about the early manifestations of this syndrome, as early diagnosis and treatment improve outcomes considerably.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1080/21548331.2018.1451205

  3 / 1412 MEDLINE  
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[PMID]: 29505002
[Au] Autor:Cappell MS; Edhi A; Amin M
[Ad] Address:Division of Gastroenterology & Hepatology, Department of Medicine, William Beaumont Hospital.
[Ti] Title:Case report of primary intestinal lymphangiectasia diagnosed in an octogenarian by ileal intubation and by push enteroscopy after missed diagnosis by standard colonoscopy and EGD.
[So] Source:Medicine (Baltimore);97(3):e9649, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Primary intestinal lymphangiectasia (PIL) is a rare, presumably congenital lesion that is usually diagnosed in patients < 3 years old, is rarely first diagnosed in adulthood, and when first diagnosed in adulthood typically presents with symptoms for many years. Although PIL is often identified by endoscopic abnormalities, it must be emphasized that the jejunoileum/distal duodenum must be intubated for diagnosis because the lesions are present in these regions. This work demonstrates that 1)-PIL can occur in an octogenarian; 2)-shows that the characteristic endoscopic findings are not found at colonoscopy without terminal ileal intubation; and 3)-may be missed at standard EGD without distal duodenal intubation. DIAGNOSES: A patient initially presented at age 83 with symptoms of watery diarrhea, abdominal distention, 5-Kg-weight-gain, and weakness for one month, and had typical clinical findings of PIL including chylous ascites, pleural effusions, bilateral pitting leg edema, hypoalbuminemia, borderline lymphopenia, hypovitaminosis-D, and hypocalcemia. Protein-losing-enteropathy was demonstrated by positive stool tests for alpha-1-antitrypsin. Standard colonoscopy revealed no significant lesions, but terminal ileal intubation during colonoscopy demonstrated creamy-white, punctate, mucosal lesions in terminal ileum, characteristic of lymphangiectasia. EGD with intubation to mid-descending duodenum revealed no significant lesions, but subsequent enteroscopy demonstrated lesions in distal duodenum/proximal jejunum similar to those in terminal ileum characteristic of lymphangiectasia. Histopathologic analysis of lesions of terminal ileum/distal duodenum demonstrated dilated mucosal vessels, confirmed as lymphatic vessels by immunohistochemistry. PIL was diagnosed after excluding secondary causes of intestinal lymphangiectasia. INTERVENTIONS/OUTCOMES: Patient placed on standard PIL diet: oral supplements of medium-chain triglycerides, a high protein diet, supplements of fat-soluble vitamins, and avoiding long-chain fatty acids, with marked clinical improvement. LESSONS: This work shows that: 1)-standard EGD and colonoscopy may miss characteristic lesions of PIL, 2)-enteroscopy or terminal ileal intubation at colonoscopy may be required for the diagnosis because lesions are typically located in distal duodenum/jejunoileum; and 3)-PIL can first present in the very elderly even with symptoms of short duration.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process
[do] DOI:10.1097/MD.0000000000009649

  4 / 1412 MEDLINE  
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[PMID]: 29480862
[Au] Autor:Yao BZ; Li L; Jiang M; Wang J; Zhang J
[Ti] Title:Refractory chyle leakage after laparoscopic cholecystectomy for gallstone disease: A case report and literature review.
[So] Source:Medicine (Baltimore);97(2):e9604, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Gallstone disease is commonly worldwide and safely treated by laparoscopic cholecystectomy. Chylous ascites is a rare but serious complication of many abdominal operations. PATIENT CONCERNS: We present a rare case of refractory chyle leakage post-LC for acute cholecystitis that is successfully treated in a 40-year-old man, and review current literature on the prevalence, diagnosis, and management of this complication. DIAGNOSES: Refractory chyle leakage post-LC, a rare but serious complication after laparoscopic cholecystectomy. INTERVENTIONS: Conservative treatment was given initially; however, the outcome was frustrating. Surgical intervention was given without further delay. OUTCOMES: After the reoperation, conservative treatment was still maintained. After nearly 8 months of treatment, the patient recovered and then was discharged. LESSONS: This case represents a previously unreported complication of refractory and high flow chyle leakage after laparoscopic cholecystectomy, which did not improve alter conservative management with dietary changes and other measures. So we suggest that surgical intervention should be given for refractory cases without further delay. It can not only shorten the disease progression, but also alleviate the sufferings of the patient.
[Mh] MeSH terms primary: Cholecystectomy, Laparoscopic/adverse effects
Cholecystitis, Acute/surgery
Chyle
Postoperative Complications
[Mh] MeSH terms secundary: Adult
Conservative Treatment
Drainage
Gallstones/surgery
Humans
Male
Reoperation
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009604

  5 / 1412 MEDLINE  
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[PMID]: 29502266
[Au] Autor:Janssen AWF; Katiraei S; Bartosinska B; Eberhard D; Willems van Dijk K; Kersten S
[Ad] Address:Nutrition, Metabolism and Genomics Group, Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708 WE, Wageningen, the Netherlands.
[Ti] Title:Loss of angiopoietin-like 4 (ANGPTL4) in mice with diet-induced obesity uncouples visceral obesity from glucose intolerance partly via the gut microbiota.
[So] Source:Diabetologia;, 2018 Mar 03.
[Is] ISSN:1432-0428
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:AIMS/HYPOTHESIS: Angiopoietin-like 4 (ANGPTL4) is an important regulator of triacylglycerol metabolism, carrying out this role by inhibiting the enzymes lipoprotein lipase and pancreatic lipase. ANGPTL4 is a potential target for ameliorating cardiometabolic diseases. Although ANGPTL4 has been implicated in obesity, the study of the direct role of ANGPTL4 in diet-induced obesity and related metabolic dysfunction is hampered by the massive acute-phase response and development of lethal chylous ascites and peritonitis in Angptl4 mice fed a standard high-fat diet. The aim of this study was to better characterise the role of ANGPTL4 in glucose homeostasis and metabolic dysfunction during obesity. METHODS: We chronically fed wild-type (WT) and Angptl4 mice a diet rich in unsaturated fatty acids and cholesterol, combined with fructose in drinking water, and studied metabolic function. The role of the gut microbiota was investigated by orally administering a mixture of antibiotics (ampicillin, neomycin, metronidazole). Glucose homeostasis was assessed via i.p. glucose and insulin tolerance tests. RESULTS: Mice lacking ANGPTL4 displayed an increase in body weight gain, visceral adipose tissue mass, visceral adipose tissue lipoprotein lipase activity and visceral adipose tissue inflammation compared with WT mice. However, they also unexpectedly had markedly improved glucose tolerance, which was accompanied by elevated insulin levels. Loss of ANGPTL4 did not affect glucose-stimulated insulin secretion in isolated pancreatic islets. Since the gut microbiota have been suggested to influence insulin secretion, and because ANGPTL4 has been proposed to link the gut microbiota to host metabolism, we hypothesised a potential role of the gut microbiota. Gut microbiota composition was significantly different between Angptl4 mice and WT mice. Interestingly, suppression of the gut microbiota using antibiotics largely abolished the differences in glucose tolerance and insulin levels between WT and Angptl4 mice. CONCLUSIONS/INTERPRETATION: Despite increasing visceral fat mass, inactivation of ANGPTL4 improves glucose tolerance, at least partly via a gut microbiota-dependent mechanism.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180304
[Lr] Last revision date:180304
[St] Status:Publisher
[do] DOI:10.1007/s00125-018-4583-5

  6 / 1412 MEDLINE  
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[PMID]: 29364009
[Au] Autor:Tallón-Aguilar L; López-Ruiz JA; Domínguez-Sánchez C; Pareja-Ciuró F; Padillo-Ruiz J
[Ad] Address:Trauma and Emergency Surgery Unit, Surgery Department, University Hospital Virgen del Rocío University , Seville , Spain.
[Ti] Title:Laparoscopic aproach in post-traumatic chylous ascites.
[So] Source:Ann R Coll Surg Engl;100(3):e57-e58, 2018 Mar.
[Is] ISSN:1478-7083
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Chylous ascites is a rare condition little reported in literature, with even more exceptional traumatic origin. Its production mechanism is not known exactly but has been attributed to hyperflexion or hyperextension of the spine leading to a rupture of lymph ducts. We present a case of post-traumatic chyloperitoneum in a young patient after abdominal blunt trauma. Conservative treatment should be the first therapeutic option, especially if the origin is traumatic, reserving more aggressive possibilities for cases that do not respond after 15 days, if debt is greater than 1.5 litres/day in adult patients or in those with metabolic complications. A laparoscopic approach is indicated to confirm the diagnosis and to rule out other associated injuries that may require other surgical procedures.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Process
[do] DOI:10.1308/rcsann.2017.0220

  7 / 1412 MEDLINE  
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[PMID]: 29273307
[Au] Autor:Geppert B; Lönnerfors C; Bollino M; Persson J
[Ad] Address:Department of Obstetrics and Gynecology, Skane University Hospital, Lund University, Lund, Sweden.
[Ti] Title:Sentinel lymph node biopsy in endometrial cancer-Feasibility, safety and lymphatic complications.
[So] Source:Gynecol Oncol;148(3):491-498, 2018 Mar.
[Is] ISSN:1095-6859
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To compare the rate of lymphatic complications in women with endometrial cancer undergoing sentinel lymph node biopsy versus a full pelvic and infrarenal paraaortic lymphadenectomy, and to examine the overall feasibility and safety of the former. METHODS: A prospective study of 188 patients with endometrial cancer planned for robotic surgery. Indocyanine green was used to identify the sentinel lymph nodes. In low-risk patients the lymphadenectomy was restricted to removal of sentinel lymph nodes whereas in high-risk patients also a full lymphadenectomy was performed. The impact of the extent of the lymphadenectomy on the rate of complications was evaluated. RESULTS: The bilateral detection rate of sentinel lymph nodes was 96% after cervical tracer injection. No intraoperative complication was associated with the sentinel lymph node biopsy per se. Compared with hysterectomy alone, the additional average operative time for removal of sentinel lymph nodes was 33min whereas 91min were saved compared with a full pelvic and paraaortic lymphadenectomy. Sentinel lymph node biopsy alone resulted in a lower incidence of leg lymphedema than infrarenal paraaortic and pelvic lymphadenectomy (1.3% vs 18.1%, p=0.0003). CONCLUSION: The high feasibility, the absence of intraoperative complications and the low risk of lymphatic complications supports implementing detection of sentinel lymph nodes in low-risk endometrial cancer patients. Given that available preliminary data on sensitivity and false negative rates in high-risk patients are confirmed in further studies, we also believe that the reduction in lymphatic complications and operative time strongly motivates the sentinel lymph node concept in high-risk endometrial cancer.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:In-Data-Review

  8 / 1412 MEDLINE  
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[PMID]: 29475120
[Au] Autor:Idota N; Nakamura M; Tojo M; Ichioka H; Shintani-Ishida K; Ikegaya H
[Ad] Address:Department of Forensic Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan. Electronic address: idotan@koto.kpu-m.ac.jp.
[Ti] Title:Infant fatality case with excessive chylous ascites.
[So] Source:Leg Med (Tokyo);32:23-26, 2018 Feb 16.
[Is] ISSN:1873-4162
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:An 11-month-old boy with marked abdominal distension was found dead in the prone position at home. Since there were many bruises in the non-protruding regions of the head, face, and abdomen, a medicolegal autopsy was performed the following day. The boy was smaller than average (height: 68.5 cm; weight: 7.8 kg); his extremities were thin; and his abdomen was remarkably bulging. Chylous ascites (1600 mL) was observed in the peritoneal cavity and chylous pleural effusion (left: 5 mL; right: 10 mL) in the thoracic cavity. A fibrous induration, approximately 2.0 × 1.5 cm in size, was observed in the root of the small bowel mesentery. Congenital chylothorax and chylous ascites were suspected. However, the remarkably withered thymus and an old injury in the superior labial frenulum suggested that the chylous ascites may have been further deteriorated by injuries sustained during physical abuse. Examination suggested that the death was sudden. Thus, we inferred that the cause of death was circulatory and respiratory failure due to excessive chylous ascites. Among the reported cases of chylous ascites in pediatric patients, some patients experiencing abuse were identified on the basis of their chief complaints of vomiting or abdominal distension. Medical and child welfare staff should be made aware of this information.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180223
[Lr] Last revision date:180223
[St] Status:Publisher

  9 / 1412 MEDLINE  
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[PMID]: 29454443
[Au] Autor:Srinivasa RN; Chick JFB
[Ad] Address:Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Michigan Medicine, Ann Arbor, Mich.
[Ti] Title:Regarding "Management of refractory chylous ascites with peritoneovenous shunts".
[So] Source:J Vasc Surg Venous Lymphat Disord;6(2):302, 2018 Mar.
[Is] ISSN:2213-3348
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1802
[Cu] Class update date: 180218
[Lr] Last revision date:180218
[St] Status:In-Data-Review

  10 / 1412 MEDLINE  
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[PMID]: 29437722
[Au] Autor:Mukherjee A; Sehgal IS; Mittal BR; Dhooria S
[Ad] Address:Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
[Ti] Title:Transudative chylothorax: an uncommon illness due to a common cause.
[So] Source:BMJ Case Rep;2018, 2018 Feb 07.
[Is] ISSN:1757-790X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Chylothorax is defined as presence of chyle in the pleural space. It is commonly associated with cardiothoracic surgery, trauma, malignancy or some benign disorders. Transudative chylothorax is uncommon. A 52-year-old man presented with bilateral chylothorax with preceding history of blunt trauma to the chest. On further evaluation, he was diagnosed to have a transudative chylothorax due to cirrhosis of liver with coexisting chylous ascites and evidence of peritoneopleural communication. The patient was managed with diuretics followed by chemical pleurodesis with iodopovidone.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:In-Process


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