Year 2016 / Volume 108 / Number 6
Case Report
Long-evolution ascites in a patient with constrictive pericarditis

368-371

DOI: 10.17235/reed.2015.3728/2015

Gonçalo Filipe Domingos Nunes, Narcisa Fatela, Fernando Ramalho,

Abstract
Constrictive pericarditis (CP) is an uncommon disease resulting from chronic pericardial inflammation, fibrosis and calcification. Once there are atypical forms of presentation, with subtle or nonexistent cardiorespiratory symptoms, diagnosis may be challenging and difficult. Recurrent ascites in patients with congestive hepatopathy due to constrictive pericarditis is common and, in most cases, reversible after pericardiectomy. Nevertheless, development of persistent liver dysfunction may be a long-term complication. The present work describes a 23 years old man with growth delay, dyspnoea and long evolution ascites, whose exhaustive etiological investigation led to diagnosis. Afterwards the patient underwent elective surgery with symptom and general condition improvement. Ascites differential diagnosis and its association with constrictive pericarditis are briefly reviewed in this article.
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References
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1) Silva D, Sargento L, Gato Varela M, et al. Pericardite Constrictiva – novos métodos no diagnóstico de uma velha doença: a propósito de um caso clínico. Rev Port Cardiol 2012; 31: 677-682.
2) Braunwald E. Pericardial Disease. In: Longo DL, Fauci AS, Kasper DL, Hauster SL, Jameson JL, Loscalzo J, Eds. Harrison´s Principles of Internal Medicine. 18th ed. Vol. 2. New York, Mc Graw Hill, 2012: 1971-1978.
3) Bertog SC, Thambidorai SK, Parakh K, et al. Constrictive pericarditis: etiology and cause-specific survival after pericardiectomy. J Am Coll Cardiol 2004; 43:1445.
4) Bayraktar UD, Seren S, Bayraktar Y. Hepatic venous outflow obstruction: Three similar syndromes. World J Gastroenterol 2007; 13: 1912-27.
5) Osterberg L, Vagelos R, Atwood JE. Case Presentation and Review: Constrictive Pericarditis. West J Med 1998; 169: 232-9.
6) Talreja DR, Nishimura RA, Oh JK, et al. Constrictive pericarditis in the modern era: novel criteria for diagnosis in the cardiac catheterization laboratory. J Am Coll Cardiol 2008; 51:315-9.
7) Bergman M, Vitrai J, Salman H. Constrictive Pericarditis: A reminder of a not so rare disease. Eur J Intern Med 2006; 17: 457-4.
8) Corey KE, Friedman LS. Abdominal Swelling and Ascites. In Longo DL, Fauci AS, Kasper DL, Hauster SL, Jameson JL, Loscalzo J, Eds. Harrison´s Principles of Internal Medicine. 18th ed. Vol. 1. New York, Mc Graw Hill, 2012: 330-3.
9) Gordon FD. Ascites. Clin Liver Dis 2012; 16: 285-99.
10) Mittal R, Dangoor A. Paracentesis in the management of ascites. Br J Hosp Med (Lond) 2007; 68: 162-5.
11) McHutchison JG. Differential diagnosis of ascites. Semin Liver Dis. 1997; 17: 191-202.
12) Alvarez AM, Mukherjee D. Liver Abnormalities in Cardiac Diseases and Heart Failure. Int J Angiol. 2011; 20: 135-42.
13) Kavoliuniene A, Vaitiekiene A, Cesnaite G. Congestive hepatopathy and hypoxic hepatitis in heart failure: A cardiologist´s point of view. Int J Cardiol. 2013 166:554-8.
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Domingos Nunes G, Fatela N, Ramalho F. Long-evolution ascites in a patient with constrictive pericarditis. 3728/2015


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Publication history

Received: 13/02/2015

Accepted: 05/05/2015

Online First: 22/07/2015

Published: 03/06/2016

Article revision time: 78 days

Article Online First time: 159 days

Article editing time: 476 days


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