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Massive Ascites of Unknown Origin: A Case Report
Magdalena Kikowicz1, Jolanta Gozdowska1, Magdalena Durlik1
1Department of Transplantation Medicine, Nephrology, and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Transplantation Proceedings
|April 12, 2020
Summary
This case study details a woman with ascites, a rare condition of fluid buildup. Despite extensive diagnostics and surgery, the ascites resolved spontaneously, highlighting a puzzling etiology.
Area of Science:
- Nephrology
- Gynecology
- Oncology
Background:
- Ascites, excessive peritoneal fluid, typically stems from liver cirrhosis, cancer, or heart failure.
- A 31-year-old woman with chronic renal failure, post-kidney transplant, experienced recurrent ascites requiring frequent paracentesis.
- Initial diagnostics ruled out infections, liver disease, and malignancy, complicating the ascites etiology.
Observation:
- Computed tomography revealed an enlarged left ovary and elevated CA 125 levels.
- Oophorectomy identified serous cysts but no malignancy; however, ascites persisted post-surgery.
- The ascites spontaneously resolved five months after oophorectomy, eliminating the need for paracentesis.
Findings:
- The patient's ascites presented an atypical and confusing etiology, unresponsive to initial treatments.
- Despite oophorectomy for suspected Meigs' syndrome, ascites recurred before spontaneous cessation.
- The exact cause of the ascites and its eventual resolution remains unclear.
Implications:
- This case underscores the importance of considering rare etiologies for ascites, even in post-transplant patients.
- The spontaneous resolution of ascites presents a unique clinical puzzle, prompting further investigation into underlying mechanisms.
- Understanding such rare cases can improve diagnostic and therapeutic strategies for refractory ascites.
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