COMPLICACIONES DE PARACENTESIS PDF

Fisiopatogenia y opciones de tratamiento. Plancarte 1 , M. Guajardo2 y F. Mayer 2. Ascites in cancer patients. Physiopathology and therapeutic options.

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Fisiopatogenia y opciones de tratamiento. Plancarte 1 , M. Guajardo2 y F. Mayer 2. Ascites in cancer patients. Physiopathology and therapeutic options. Rev Soc Esp Dolor ; Ascites, defined as the presence of fluid in the peritoneal cavity, is a finding associated to several pathologies, mainly hepatic and cancer diseases.

Between 15 and 50 per cent of patients with cancer develop ascites. Its incidence is high in ovary, breast, endometrium, colon, stomach, pancreas and bronchus cancer. Several factors are involved in its pathogenesis, included high hydrostatic pressure, low colloid-osmotic pressure, increased capillary permeability and fluid leakage to the peritoneal cavity. The ascitic fluid is analyzed for diagnostic serum-ascitic albumin gradient, amylase and triglyceride levels; cell count, culture and Gram staining; pH, cytology, glucose and fibronectine determination and therapeutic purposes.

A physical examination is essential for the diagnosis, with particular attention to classical signs such as convex flanks, wave sign, pleural effusion sign, limb, pelvic and genital edema, etc. Other specific studies are sometimes required in order to verify the presence of fluid in the abdominal cavity. Its treatment will depend on the etiology. In non-cancer patients, diet salt restriction and diuretics regimes obtain satisfactory results.

In cancer patients, intra-peritoneal chemotherapy may be required. Patients with poor or null response are candidates for drainage of the ascitic fluid. This can be done using several techniques such as classical paracentesis, total paracentesis, placement of a semi-permanent or permanent drainage with or without image help, shunts, etc. In order to obtain the maximum benefit with the minimum risk, patient global status must be assessed prior to the procedure.

It is concluded that ascites of any etiology encompass diverse physiopathological disorders that require both pharmacological and invasive therapies for their effective management. Palabras clave: Ascitis. En pacientes con gradientes mayores o iguales a 1,1 g. Si el tratamiento es efectivo puede repetirse a intervalos. Dentro de los agentes que pueden ser efectivos se incluyen a la bleomicina 15 U , 5- fluoracilo 1.

Se ha considerado dicho procedimento como conveniente costo-efectividad, reduciendo el ingreso repetido de pacientes para drenaje. L -1 a las 6 semanas. Los adenocarcinomas mucinososos, tumores benignos productores de mucina y los mucoceles apendiculares pueden producir abundante material gelatinoso que es imposible retirar mediante paracentesis. Con un promedio de drenaje diario de ,5 ml Friedman L, Isselbacher K.

Principios de Medicina Interna. Madrid: Ed. Interamericana McGraw-Hill; Reis E. Ascites evaluation and treatment Medstudents-Internal Medicine. Gary F. Nov Waller A. In: Handbook of Palliative Care in Cancer. Butterworth Heinemann, Runyon BA. Care of patients with ascites. N Engl J Med ; Claud R. Management of ascites in advanced cancer -a flow diagram. Palliative Medicine ; 4: Malignancy-related ascites: a diagnostic pit fall of spontaneous bacterial peritonitis by ascites fluid polymorphonuclear cell count.

J Hepatol ; In: Casciato AD. Manual of Clinical Oncology. Runyon A. Editorial: Malignancy-related. Ascites and ascitic fluid. Humoral test of malignancy. J Clin Gastroenterol ; Gotlieb WH, Heldman B. Intraperitoneal pressures and clinical parameters of total paracentesis for palliation of symptomatic ascites in ovarian cancer. Gynecologic Oncology ; Intraoperative placement of a self-retaining Foley catheter for continuous drainage on malignant ascites. Eur J Gynaecol Oncol ; Tunneled peritoneal cateter placement under sonographic and fluoroscopic guidance on the palliative treatment of malignant ascites.

Am J Roentgenol ; Sonographically guided peritoneal cateter placement in the palliation of malignant ascites in end-stage malignancies. Temporary drainage of symptomatic malignant ascites by a catheter iserted under computerized tomography. J Pain Symptom Manage ; McNamara, P. Paracentesis -an effective meted of symptom control in the palliative care setting?

Intraperitoneal pressures and clinical parameters of total paracentesis for palliation symptomatic ascites in ovarian cancer. Gynecol Oncol ; Management of symptomatic ascites in recurrent ovarian cancer patients using an intrabdominal semi-permanent catheter. Am J Hosp Palliat Care ; Barnett TD, Rubins J.

Placement of a permanent tunneled peritoneal drainage catheter for palliation of malignant ascites: a simplified percutaneous ap-proach. J Vasc Interv Radiol; Palliative treatment of malignant refractory ascites by positioning of Denver peritoneovenosus shunt. Intraoperative placement of a self-retaining Foley cateter for continuous drainage of malignant ascities. European Journal Gynaecology Oncology ; Pleurx tunneled catheter in the management of malignant asicites. Journal Vascular Interventional Radiology ; 12 3 : Indwelling catheters for the management of malignant ascites.

Support Care Cancer ; 8 6 : Servicios Personalizados Revista. Fisiopatogenia y opciones de tratamiento R. SUMMARY Ascites, defined as the presence of fluid in the peritoneal cavity, is a finding associated to several pathologies, mainly hepatic and cancer diseases. Key words : Ascites. Hepatic disease. Aceptado : San Fernando, 22 C.

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Cirrosis hepática: manejo moderno de antiguas complicaciones

Runyou BA. Management of adult patients with ascites due to cirrhosis: an up date. Transyugular intrahepatic portosystemic shunt for refractory ascites: a meta analysis of individual patient data. Midridines versus albumin in the prevention of paracentesis-induce circulatory dysfunction in the cirrotics: a randomized pilot study.

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Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. DOI: Generalidades Las complicaciones de la cirrosis hepatica no han cambiado a lo largo del tiempo, pero si lo han hecho las opciones de tratamiento, en especial durante los ultimos ocho anos. View PDF. Save to Library.

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