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Doctors Lounge - Gastroenterology Answers
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| nursery23
- Fri Apr 29, 2005 1:41 pm |
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Any information would be appreciated.
59 year old male with history of heavy drinking presents with massive intractable ascites and chronic bronchitis. Liver function is normal. Colonoscopy normal. CT scan normal. No cirrhosis seen. No enlargement of the liver or spleen. No malignancy found. No cardiac abnormalities. No TB. No fungus or paracites. The ascites is so massive and rapidly occurring that it requires weekly therapeudic paracentisis. Any ideas as to a cause? I don't know the serum albumin gradient.Could it be lymphoma or pancreatic cancer. Or possible hypothyroidism.
Thanks,
Steve
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| Dr. Tamer Fouad
- Sun May 01, 2005 5:38 am |
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 The appropriate step would be to submit the ascitic fluid for cytological evaluation and various other laboratory assessments (including bacteriological). Malignancy is only ruled out after the results of cytological evaluation comes out REPEATEDLY negative (usually 3 times). Given his age a panel of tumor markers may also be appropriate.
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