Gliomatosis peritonei (GP) is a condition characterized by the dissemination of mature glial tissues throughout the peritoneal cavity. It is usually associated with immature ovarian teratoma but presents with mature cystic teratoma (MCT) in 1% of cases. GP, associated with MCT, is a benign disorder. The majority of cases remain asymptomatic and rarely recur. Here, we present a case of a 22-year-old woman with a history of abdominal enlargement and severe abdominal pain who underwent exploratory laparotomy, peritoneal fluid cytology, bilateral salpingo-oophorectomy, appendectomy, omental biopsy, and Jackson-Pratt drain insertion with histopathologic result of GP with MCT. A month later, the patient had a recurrence of abdominal enlargement, necessitating a second surgery. Immunohistochemistry for histopathologic evaluation and diagnostic imaging are crucial in confirming the diagnosis and guiding the treatment strategy. A multidisciplinary team approach in monitoring and comprehensive support is significant in optimizing outcomes for patients with aggressive GPs associated with MCT. Further research and clinical experience are essential to establish a standardized guideline to improve the management and clinical outcome of this condition.

A boy, aged 17 years, was admitted again due to abdominal pain, diarrhea, and eosinophilia for 3 years, which worsened for 3 days. Three years ago, the boy suffered from abdominal pain and diarrhea after eating yogurt; color Doppler ultrasound showed a large amount of peritoneal effusion, and routine blood test, bone marrow cell morphology, and ascites histological examination showed a large number of eosinophils. Three days ago, he was admitted again due to abdominal pain and diarrhea. The gastrointestinal endoscopy showed eosinophil infiltration in the angle of stomach. The boy was diagnosed with eosinophilic gastrointestinal disease (eosinophilic gastroenteritis). He was improved after the treatment with glucocorticoids and dietary avoidance, and no recurrence was observed during the one-year follow-up. It is concluded that for children who attend the hospital due to gastrointestinal symptoms such as abdominal pain and diarrhea, if there is an increase in peripheral blood eosinophils, it is necessary to consider the possibility of eosinophilic gastrointestinal disease, and eosinophil infiltration and abnormal eosinophil count in gastrointestinal tissue based on endoscopic biopsy may be the key to diagnosis.
Abdominal Pain/etiology* ; Ascitic Fluid ; Enteritis ; Eosinophilia/etiology* ; Gastritis ; Humans ; Male

Ascitic Fluid ; Consensus ; Humans ; Pleural Effusion

A differential diagnosis of ascites is always challenging for physicians. Peritoneal tuberculosis is particularly difficult to distinguish from peritoneal carcinomatosis because of the similarities in clinical manifestations and laboratory results. Although the definitive diagnostic method for ascites is to take a biopsy of the involved tissues through laparoscopy or laparotomy, there are many limitations in performing biopsies in clinical practice. For this reason, physicians have attempted to find surrogate markers that can substitute for a biopsy as a confirmative diagnostic method for ascites. CA 125, which is known as a tumor marker for gynecological malignancies, has been reported to be a biochemical indicator for peritoneal tuberculosis. On the other hand, the sensitivity of serum CA 125 is low, and CA 125 may be elevated due to other benign or malignant conditions. This paper reports the case of a 66-year-old male who had a moderate amount of ascites and complained of dyspepsia and a febrile sensation. His abdominal CT scans revealed a conglomerated mass, diffuse omental infiltration, and peritoneal wall thickening. Initially, peritoneal tuberculosis was suspected due to the clinical symptoms, CT findings, and high serum CA 125 levels, but non-specific malignant cells were detected on cytology of the ascitic fluid. Finally, he was diagnosed with primary malignant peritoneal mesothelioma after undergoing a laparoscopic biopsy.
Aged ; Ascites ; Ascitic Fluid ; Biomarkers ; Biopsy ; CA-125 Antigen ; Carcinoma ; Diagnosis, Differential ; Dyspepsia ; Hand ; Humans ; Laparoscopy ; Laparotomy ; Male ; Mesothelioma ; Methods ; Peritoneum ; Peritonitis, Tuberculous ; Sensation ; Tomography, X-Ray Computed

OBJECTIVE: To observe the clinical efficacy of adjuvant therapy of moxibustion combined with formula for peritoneal effusion of ovarian malignant tumors. METHODS: Sixty patients with peritoneal effusion of ovarian malignant tumors were randomly divided into an observation group and a control group, 30 cases in each group. The patients in the control group were treated with intravenous infusion of paclitaxel liposome at the first day and cisplatin at the 2nd to 4th day, 21 days as a course of treatment, and 4 courses were given. Based on the treatment of the control group, the patients in the observation group were treated by moxibustion combined with formula. Moxibustion was applied at Mingmen (GV 4), Pishu (BL 20), Shenshu (BL 23), Shenque (CV 8), Guanyuan (CV 4), Zigong (EX-CA 1), Zhongwan (CV 12), Shuifen (CV 9), Qihai (CV 6) and Zhongji (CV 3), each acupoint for 30 min, once a day for 12 weeks. formula was taken twice orally, one dose a day, 2 weeks as a course of treatment, and 6 courses were given. The levels of , , and / in peripheral blood were measured before and after 12-week treatment in the two groups. The changes of peritoneal effusion volume and Karnofsky performance status scale (KPS) score before and after treatment were compared between the two groups, and the clinical efficacy of the two groups was evaluated. RESULTS: The symptom improvement rate was 96.7% (29/30) and overall effective rate was 86.7% (26/30) in the observation group, which were significantly superior to those in the control group [80.0% (24/30) and 56.7% (17/30), <0.05]. After treatment, the levels of , and / in peripheral blood were significantly increased in the observation group (<0.01), there was no significant difference in the control group before and after treatment (>0.05), and the increase in the observation group was significantly higher than that in the control group (<0.05). After treatment, the volume of peritoneal effusion in the two groups was decreased (<0.01), and the reduced volume in the observation group was higher than that in the control group (<0.05). After treatment, KPS scores were increased significantly in both two groups (<0.01), and the increase in the observation group was higher than that in the control group (<0.05). The incidence rate of adverse reactions in the observation group was lower than that in the control group [23.3% (7/30) vs 53.3% (16/30), <0.05]. CONCLUSION Moxibustion combined with formula could effectively improve the immune function, reduce the volume of peritoneal effusion, improve the symptom improvement rate, overall effective rate and the quality of life, and reduce the incidence of adverse reactions in chemotherapy of patients with peritoneal effusion of ovarian malignant tumors.
Acupuncture Points ; Ascitic Fluid ; Humans ; Moxibustion ; Neoplasms ; Quality of Life

No abstract available.
Ascitic Fluid ; Carcinoma, Endometrioid ; Carcinoma, Neuroendocrine ; Endometrium ; Female

The goals of this study were, first, to evaluate the feasibility of inducing gastric perforation with 99% alcohol injection after electrocautery (EA-method), and, second, to observe “enhanced peritoneal stripe sign (EPSS)” and other lesions upon induction of gastric perforation. Six clinically normal beagle dogs were prepared for gastric perforation using endoscopy. After gastric perforation, EPSS and other lesions on ultrasonography were observed eventually (at 0 h, 3 h, day 1, day 2, day 3, day 4, day 5, and day 6). We graded the EPSS depending on its width and number. EPSS was observed until day 4 of the examination in all the 6 dogs. The grades of EPSS were the highest at 3 h and declined gradually. Peritoneal effusion was observed in all dogs at 3 h and on day 1. Regional bright mesenteric fat was confirmed in all dogs on days 3 and 4. In conclusion, gastric perforation can be induced by EA-method. EPSS and peritoneal effusion appear at a very early stage, and regional bright mesenteric fat was identified on days 3 and 4 in almost all dogs with gastric perforation.
Animals ; Ascitic Fluid ; Dogs ; Electrocoagulation ; Endoscopy ; Pneumoperitoneum ; Ultrasonography

A differential diagnosis of ascites is always challenging for physicians. Peritoneal tuberculosis is particularly difficult to distinguish from peritoneal carcinomatosis because of the similarities in clinical manifestations and laboratory results. Although the definitive diagnostic method for ascites is to take a biopsy of the involved tissues through laparoscopy or laparotomy, there are many limitations in performing biopsies in clinical practice. For this reason, physicians have attempted to find surrogate markers that can substitute for a biopsy as a confirmative diagnostic method for ascites. CA 125, which is known as a tumor marker for gynecological malignancies, has been reported to be a biochemical indicator for peritoneal tuberculosis. On the other hand, the sensitivity of serum CA 125 is low, and CA 125 may be elevated due to other benign or malignant conditions. This paper reports the case of a 66-year-old male who had a moderate amount of ascites and complained of dyspepsia and a febrile sensation. His abdominal CT scans revealed a conglomerated mass, diffuse omental infiltration, and peritoneal wall thickening. Initially, peritoneal tuberculosis was suspected due to the clinical symptoms, CT findings, and high serum CA 125 levels, but non-specific malignant cells were detected on cytology of the ascitic fluid. Finally, he was diagnosed with primary malignant peritoneal mesothelioma after undergoing a laparoscopic biopsy.
Aged ; Ascites ; Ascitic Fluid ; Biomarkers ; Biopsy ; CA-125 Antigen ; Carcinoma ; Diagnosis, Differential ; Dyspepsia ; Hand ; Humans ; Laparoscopy ; Laparotomy ; Male ; Mesothelioma ; Methods ; Peritoneum ; Peritonitis, Tuberculous ; Sensation ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Early diagnosis of peritoneal metastases in patients with colorectal cancer (CRC) can influence patient prognosis. The aim of this study was to identify the clinical significance of carcinoembryonic antigen (CEA) in peritoneal fluid detected during operation in stage I–III CRC patients. METHODS: Between April 2009 and April 2015, we reviewed medical records from a total of 60 stage I–III CRC patients who had peritoneal fluid collected during operation. Patients who had positive cytology in the assessment of peritoneal fluid were excluded. We evaluated the values of CEA in peritoneal fluid (pCEA) to predict the long-term outcomes of these patients using Kaplan-Meier curves and Cox regression models. RESULTS: The median follow-up duration was 37 months (interquartile range, 21–50 months). On receiver operating characteristic analysis, pCEA had the largest area under the curve (0.793; 95% confidence interval, 0.635–0.950; P=0.001) with an optimal cutoff value of 26.84 (sensitivity, 80.0%; specificity, 76.6%) for predicting recurrence. The recurrence rate was 8.1% in patients with low pCEA ( < 26.84 ng/mL, n=37), and 52.2% in patients with high pCEA (≥26.84 ng/mL, n=23). In multivariate Cox regression analysis, high pCEA (≥26.84 ng/mL) was a risk factor for poor cancer-free survival (CFS) in stage I–III patients. CONCLUSIONS: In this study, we determined that high pCEA (≥26.84 ng/mL) detected during operation was helpful for the prediction of poor CFS in patients with stage I–III CRC.
Ascitic Fluid* ; Carcinoembryonic Antigen* ; Colorectal Neoplasms* ; Early Diagnosis ; Follow-Up Studies ; Humans ; Medical Records ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Risk Factors ; ROC Curve ; Sensitivity and Specificity

Umbilical venous catheterization (UVC) is a common practice in intensive neonatal care. However, a malpositioned UVC and its prolonged use may lead to various problems, including mechanical, infectious, and thrombotic complications in various organs such as the liver, lungs, and heart. Congenital chylous ascites is characterized by abnormally high levels of triglycerides in the peritoneal fluid of newborns, which originate from refluxed lymph within the abdominal cavity. Herein, we report a case of an UVC complication presenting as chyloperitoneum simulating congenital chylous ascites in a preterm neonate that resulted from total parenteral nutrition (TPN) extravasation from a malpositioned UVC. Biochemical analysis of intraperitoneal chylous fluid and TPN infusate could help confirm the origin of chyloperitoneum. This case suggests that TPN extravasation from UVC should be considered when chyloperitoneum develops in newborns with an indwelling catheter. UVC positions must also be carefully monitored at regular intervals to recognize associated complications early, particularly in cases with an inevitably malpositioned catheter related to the anatomy of the vessel course.
Abdominal Cavity ; Ascitic Fluid ; Catheterization ; Catheters* ; Catheters, Indwelling ; Chylous Ascites* ; Heart ; Humans ; Infant, Newborn* ; Liver ; Lung ; Parenteral Nutrition, Total* ; Triglycerides