Symptoms of a peritoneal progression from ovarian cancer are nonspecific such as abdominal pain, abdominal distention and more. Many imaging studies and serum CA-125 help diagnosis. However, it is difficult to exclude the instances of the diffuse peritoneal diseases that mimic carcinomatosis. The elevated CA-125 level usually correlates with the peritoneal carcimatosis, but it is often found in other peritoneal diseases. Therefore, the pathologic confirmation is necessary because of other mimicking diseases. In our case, CA-125 levels were elevated. Abdominal computed tomography finding was suspected a peritoneal tuberculosis but the pathologic result was the peritoneal carcimatosis, eventually.
Abdominal Pain ; Carcinoma* ; Diagnosis ; Ovarian Neoplasms ; Peritoneal Diseases ; Peritonitis, Tuberculous*

Sclerosinng mesenteritis is a rare disease that occurs most often among middle aged man. Fewer than 200 cases have been reported in the literature. It is a benign mesenteric lesion characterized by fat necrosis, fibrosis and chronic inflammation. The pathogenesis of this disease is unclear through an autoimmune origin has been proposed. The disease is generally localized and self- limiting. Fatal case is rare but has been reported. In patients with biopsy proven sclerosing mesenteritis having a relentless downhill course, treatment with prednisolone and oral cyclophosphamide in isolated case report has lead to evident clinical and radiological responses. This is a report of a case of sclerosing mesenteritis, who presented to us with history of colicky abdominal pain and weight loss. She was treated with prednisone and intravenous cyclophosphamide pulse therapy and resulted in radiological and clinical improvement. Interestingly this case has associated with skin panniculitis and pleural thickening. The skin panniculitis also showed good response to prednisolone. Our case is the first in which sclerosing mesenteritis was associated with pleural thickening.
Abdominal Pain ; Biopsy ; Cyclophosphamide ; Fat Necrosis ; Fibrosis ; Humans ; Inflammation ; Middle Aged ; Panniculitis* ; Panniculitis, Peritoneal* ; Prednisolone ; Prednisone ; Rare Diseases ; Skin* ; Weight Loss

Sclerosing mesenteritis is a rare disease presenting as chronic inflammation and fibrosis of mesentery around the small and large intestine. And in most cases, it shows indolent and benign clinical course resulting in favorable prognosis. It is often diagnosed through characterized radiologic finding in abdominal examinations including computed tomography scan. However, it is important to rule out other conditions involving mesentery when diagnosing sclerosing mesenteritis. In the case of malignancy, the method of treatment and prognosis can be completely different therefore thorough examinations are essential. We herein report a 75-year-old male who suffered from frequent diarrhea and weight loss. Initially, he was diagnosed with sclerosing mesenteritis through abdominal computed tomography scan showing "misty" soft-tissue attenuation around the mesenteric vessel. However, follow up positron emission tomography scan and biopsy finding confirmed the common bile duct cancer with lymph node metastasis.
Aged ; Biopsy ; Cholangiocarcinoma* ; Common Bile Duct ; Diarrhea ; Fibrosis ; Follow-Up Studies ; Humans ; Inflammation ; Intestine, Large ; Lymph Nodes* ; Male ; Mesentery ; Methods ; Neoplasm Metastasis* ; Panniculitis ; Panniculitis, Peritoneal* ; Positron-Emission Tomography ; Prognosis ; Rare Diseases ; Weight Loss

Sclerosing mesenteritis is a rare disease presenting as chronic inflammation and fibrosis of mesentery around the small and large intestine. And in most cases, it shows indolent and benign clinical course resulting in favorable prognosis. It is often diagnosed through characterized radiologic finding in abdominal examinations including computed tomography scan. However, it is important to rule out other conditions involving mesentery when diagnosing sclerosing mesenteritis. In the case of malignancy, the method of treatment and prognosis can be completely different therefore thorough examinations are essential. We herein report a 75-year-old male who suffered from frequent diarrhea and weight loss. Initially, he was diagnosed with sclerosing mesenteritis through abdominal computed tomography scan showing "misty" soft-tissue attenuation around the mesenteric vessel. However, follow up positron emission tomography scan and biopsy finding confirmed the common bile duct cancer with lymph node metastasis.
Aged ; Biopsy ; Cholangiocarcinoma* ; Common Bile Duct ; Diarrhea ; Fibrosis ; Follow-Up Studies ; Humans ; Inflammation ; Intestine, Large ; Lymph Nodes* ; Male ; Mesentery ; Methods ; Neoplasm Metastasis* ; Panniculitis ; Panniculitis, Peritoneal* ; Positron-Emission Tomography ; Prognosis ; Rare Diseases ; Weight Loss

Encapsulating peritonitis (EP) is a rare disease characterized by the formation of a membrane which encases all or part of the abdominal viscera. This disease occurs in patients receiving continuous ambulatory peritoneal dialysis (CAPD). Other etiologies are trauma, colitis, chemical irritation, and infrequently, intraperitoneal tuberculosis. The overall prevalence is 0.7-3.7% of the patients receiving CAPD. EP may be accompanied by intestinal obstruction, strangulation, poor wound healing, and nutritional problems. The diagnosis is usually made by using an exporatory laparotomy, and the treatment of choice is excision of the membrane with complete decortication. Here, we present a case of encapsulating peritonitis associated with tuberculous peritonitis. In this patient, a huge pseudocyst, 40 cm in its largest diameter and 7 kg in weight, was found intraperitoneally. The pseudocyst was removed surgically and proved to be formed due to tuberculous peritonitis by using Tbc-PCR.
Colitis ; Diagnosis ; Humans ; Intestinal Obstruction ; Laparotomy ; Membranes ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis* ; Peritonitis, Tuberculous ; Prevalence ; Rare Diseases ; Tuberculosis ; Viscera ; Wound Healing

Pediatric mesenteric panniculitis is an extremely rare disease of unknown etiology characterized by chronic inflammation, fat necrosis, and fibrosis in the mesenteric adipose tissue. A previously healthy 13-year-old boy was admitted because of right upper abdominal pain. An abdominal computed tomography scan revealed increased attenuation and enhancement in the left upper abdominal omental fat and anterior peritoneal wall thickening. A laparoscopic biopsy showed mesenteric panniculitis with chronic inflammation, adiponecrosis, and septal fibrosis. Serological tests for autoimmune diseases, nested polymerase chain reaction for Mycobacterium tuberculosis, and special immunohistochemical stains for malignancy were all negative. Symptomatic improvement and improved abnormal findings were achieved after an 8-month treatment with prednisolone according to a follow-up abdominal computed tomography scan. Here, we report a case of pediatric mesenteric panniculitis treated with prednisolone.
Abdominal Pain ; Adipose Tissue ; Adolescent ; Autoimmune Diseases ; Biopsy ; Child ; Coloring Agents ; Fat Necrosis ; Fibrosis ; Follow-Up Studies ; Humans ; Inflammation ; Male* ; Mycobacterium tuberculosis ; Panniculitis, Peritoneal* ; Polymerase Chain Reaction ; Prednisolone* ; Rare Diseases ; Serologic Tests

PURPOSE: When liver cirrhosis patients accompanying ascites need renal replacement therapy because of chronic renal failure (CRF), peritoneal dialysis (PD) can allow direct removal of ascites and prevent anticoagulants use. However, since PD might aggravate hypoalbuminemia and increase chances of peritonitis, clinicians tend to hesitate to apply it to those patients. The aim of the present study is to assess the outcome and stability of PD for the treatment of CRF patient with cirrhosis acompanying ascites. METHODS: A retrospective study based on the clinical records was performed in cirrhotic patients with ascites in whom PD was performed for the treatment of CRF and who were followed up at Samsung Medical Center unit, between January 1995 and July 2005. RESULTS: In our study, 15 patients were enrolled. Child-pugh class was worse in non-survival group than survival group (p<0.01). One-year patient survival was 40% in Class C and 75% in Class B, and patient survival differed between Class C and Class B (p=0.0014). Causes of death were terminal liver failure (n=6) and sepsis due to pneumonia (n=1). Total 27 episodes of peritonitis occurred, and the peritonitis rates were 0.91 episodes/patients-year. CONCLUSION: Although the peritonitis rates turned out somewhat high, the use of PD for the treatment of CRF in patients with liver cirrhosis accompanying ascites seems to be safe and effective. Main cause of death in our study seems to be related to liver disease.
Anticoagulants ; Ascites* ; Cause of Death ; Fibrosis ; Humans ; Hypoalbuminemia ; Kidney Failure, Chronic* ; Liver Cirrhosis ; Liver Diseases ; Liver Failure ; Peritoneal Dialysis* ; Peritonitis ; Pneumonia ; Renal Replacement Therapy ; Retrospective Studies ; Sepsis

Relapsing polychondritis is a rare disease characterized by widespread destructive inflammatory lesions, involving cartilaginous tissue throughout the body. Commonly involved organs include the external ear, nose, joints, eyes, tracheobronchial tree, cardiovascular system and cutaneous tissues. Erythema nodosum or mesenteric panniculitis have sometimes been described in association with relapsing polychondritis, but cutaneous panniculitis is rarely reported in relapsing polychondritis. We report here a relapsing polychondritis patient who developed cutaneous panniculitis, which was resolved by corticosteroid therapy.
Cardiovascular System ; Ear, External ; Erythema Nodosum ; Humans ; Joints ; Nose ; Panniculitis* ; Panniculitis, Peritoneal ; Polychondritis, Relapsing* ; Rare Diseases

Antibiotic associated colitis due to Clostridium difficile is a common infection associated with significant morbidity. In severe cases, Pseudomembranous colitis (PMC) may be associated with intraperitoneal fluid accumulation. Howwver, the characteristics of the liquid are seldom described. This case report describes PMC patients who were presented with low serum-ascites albumin gradients (SAAG)and neutrocytic ascites, without evidence of infectious, malignant, or inflammatory peritoneal disease. The characteristics of their fluid specimens and the possible pathogenic mechanisms are discussed. These findings suggest that PMC without bowel perforation or spontaneous bacterial peritonitis.
Ascites* ; Clostridium difficile ; Enterocolitis, Pseudomembranous* ; Humans ; Peritoneal Diseases ; Peritonitis

Encapsulating peritoneal sclerosis (EPS) is an uncommon but fatal complication of peritoneal dialysis (PD). Recently, there were some reports of advanced EPS cases that were successfully treated by enterolysis although an intestinal perforation or leakage from intestinal anastomosis were associated with a high mortality. We experienced a case of EPS in a 53-year-old man on PD for 3.5 years without a previous history of episode of peritonitis who presented with hemoperitoneum during treatment of peritonitis. EPS was diagnosed radiologically according to typical CT findings; The series of CT scans revealed how to develop in sequence from a very subtle findings to full-blown findings of EPS. Enterolysis was performed because the patient did not respond to conservative management such as cessation of PD with transfer to hemodialysis, nutritional support and steroid therapy. In spite of intestinal perforation during surgery, he was successfully treated with enterolysis. Therefore, we report this case with review of the literature.
Hemoperitoneum ; Humans ; Intestinal Perforation ; Middle Aged ; Nutritional Support ; Peritoneal Dialysis ; Peritoneal Fibrosis ; Peritonitis ; Renal Dialysis ; Sclerosis