Puneet Chhabra1, Sushant Soni2, Hunny Khurana3. 1. Department of Gastroenterology, Yashoda Superspeciality Hospital, Kaushambi, Ghaziabad, India. 2. Soni Diagnostics, New Delhi, India. 3. Department of Medicine, Government Medical College and Hospital, Sector-32, Chandigarh, India.
Abstract
INTRODUCTION: Ascites in patients with cardiac disease can be multifactorial. Serum ascitic albumin gradient (SAAG) helps in identifying the etiology of ascites. High SAAG ascites is related to hepatic or posthepatic causes. The causes of low SAAG ascites results include tuberculosis, peritoneal malignancy, or pancreatitis. CASE PRESENTATION: We report an unusual cause of low SAAG ascites in a 48-year-old woman with valvular heart disease. The patient presented with ascites, and cross-sectional imaging revealed a right iliac fossa mass with omental deposits. The patient was finally diagnosed as having pseudomyxoma peritonei on the basis of clinicoradiopathological features. DISCUSSION: Pseudomyxoma peritonei is a rare cause of low SAAG ascites. It is characterized by the deposition of mucinous material on the peritoneal surfaces. The most common site of origin is the appendix, although it can arise from other intraabdominal organs as well. Excision of the tumor combined with intraperitoneal chemotherapy is the preferred modality of treatment.
INTRODUCTION:Ascites in patients with cardiac disease can be multifactorial. Serum ascitic albumin gradient (SAAG) helps in identifying the etiology of ascites. High SAAGascites is related to hepatic or posthepatic causes. The causes of low SAAG ascites results include tuberculosis, peritoneal malignancy, or pancreatitis. CASE PRESENTATION: We report an unusual cause of low SAAG ascites in a 48-year-old woman with valvular heart disease. The patient presented with ascites, and cross-sectional imaging revealed a right iliac fossa mass with omental deposits. The patient was finally diagnosed as having pseudomyxoma peritonei on the basis of clinicoradiopathological features. DISCUSSION: Pseudomyxoma peritonei is a rare cause of low SAAG ascites. It is characterized by the deposition of mucinous material on the peritoneal surfaces. The most common site of origin is the appendix, although it can arise from other intraabdominal organs as well. Excision of the tumor combined with intraperitoneal chemotherapy is the preferred modality of treatment.
Authors: Cyril Omohwo; Carol A Nieroda; Kimberley D Studeman; Heather Thieme; Paula Kostuik; Alexander S Ross; Darlene R Holter; Vadim Gushchin; Barry Merriman; Armando Sardi Journal: J Am Coll Surg Date: 2009-07-09 Impact factor: 6.113