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Respiratory distress due to malignant ascites palliated by hyperthermic intraperitoneal chemotherapy

World Journal of Gastrointestinal Surgery 2015年第3期7卷 39-42页

作者： Marijn Marinus Leonardus van den Houten Thijs Ralf van Oudheusden Michael derek Philip Luyer Simon Willem Nienhuijs ignace hubertus johannes theodorus de hingh department of Surgery Catharina Hospital

Malignant ascites is a common symptom in patients with peritoneal cancer. Current assumption is that anincreased vascular permeability and obstruction of lymphatic channels lead to the accumulation of fluid in the abdominal cavity. This case report describes a severely symptomatic patient with malignant ascites. The previously healthy 73-year-old male was presented with abdominal distention causing respiratory distress. Computed tomography revealed large amounts of ascites, a recto-sigmoidal mass with locoregional lymphadenopathy and an omental cake. Biopsy taken during colonoscopy revealed an adenocarcinoma of the colon with signet cell differentiation. A widespread peritoneal carcinomatosis was found during a diagnostic laparoscopy. The extent of peritoneal disease rendered the patient not suitable for cytoreductive surgery with curative intent. The ascites proved to be refractory to ultrasound-guided paracentesis; thus, a decision was made to perform palliative hyperthermic intraperitoneal chemotherapy without cytoreductive surgery. Consequently, ascites production stopped, and the respiratory distress was relieved thereafter. The postoperative recovery was uneventful. Ascites recurred eight months later, and a second hyperthermic intraperitoneal chemotherapy procedure was performed. The patient was still alive at the time of writing, 16 mo after the initial diagnosis.

关键词： Ascites Intraperitoneal chemotherapy Palliative hyperthermic intraperitoneal chemotherapy Peritoneal carcinomatosis Colorectal cancer

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Giant cystic lymphangioma originating from the lesser curvature of the stomach

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World Journal of Gastrointestinal Surgery 2013年第10期5卷 264-267页

作者： Thijs Ralf van Oudheusden Simon Willem Nienhuijs Thomas Bernard Joseph demeyere Michael derek Philip Luyer ignace hubertus johannes theodorus de hingh department of Surgery Catharina Hospital

Cystic lymphangiomas are rare benign *** frequently occurring in children and involving the neck or axilla,these tumors are much less common in adults and very rarely involve the *** known congenital and acquired(traumatic)etiologies result in failure of the lymphatic channels and consequent proliferation of lymphatic *** case report describes a very rare case of a giant mesenteric cystic lymphangioma in an adult male with no clear etiology and successful resolution by standard radical resection.A previously healthy 44-year-old male presented with a 6-wk history of progressive upper abdominal pain,vomiting,anorexia and unintentional weight loss accompanied by rapid abdominal distension.A palpable mass was detected upon physical examination of the distended abdomen and abdominal computed tomography scan showed a giant multilobulated cystic process,measuring 40 cm in *** laparotomy revealed an enormous cystic mass containing 6 L of serous *** process appeared to originate from the lesser omentum and the lesser curvature of the *** resection of the tumor was performed along with a partial gastrectomy to address potential invasion into the adjacent *** analysis confirmed the diagnosis of a multicystic *** postoperative recovery was uneventful and the patient was discharged after 6 *** 3-mo follow-up,the patient was in good health with no signs of recurrence.

关键词： Multicystic lymphangioma Mesentery Cystic process Abdominal pain Abdominal distension

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