Bloody ascites in sarcoidosis

Area of Science:

• Gastroenterology
• Pulmonology
• Pathology

Background:

• Sarcoidosis is a multisystem granulomatous disease of unknown etiology.
• Abdominal sarcoidosis can present with ascites, though typically nonbloody.
• Bloody effusions are known complications in other serous cavities.

Observation:

• Two patients presented with bloody ascites secondary to sarcoidosis.
• Histopathological examination revealed granulomas on peritoneal surfaces, spleen, and liver.
• This presentation is rare compared to previously reported cases of nonbloody ascites in abdominal sarcoidosis.

Findings:

• Bloody ascites in sarcoidosis is an infrequent but documented clinical manifestation.
• The presence of granulomas confirms sarcoid involvement of the peritoneum and associated organs.
• This finding expands the spectrum of ascites presentations in abdominal sarcoidosis.

Implications:

• Bloody ascites should be considered in the differential diagnosis of unexplained ascites, particularly in patients with a history or suspicion of sarcoidosis.
• The prognosis for patients with peritoneal sarcoidosis and ascites appears favorable.
• Further research may elucidate the mechanisms behind bloody ascites in sarcoidosis and optimize management strategies.