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Suggest Treatment For Abdominal Ascites
Question: I am desperateley looking for a Doctor who specializes in ASCITES. After having a laproscopic hysterectomy, I have developed severe abdominal ascites. the Doctor's have ruled out all of the usual causes for this ascites and we are at complete standstill. I often undergo Paracentesis but the fluid does not slow down.
( this is not chylous per doctor)
please.. can you send me names of any type of doctor who may specialize in this. I am willing to go anywhere in the world at this point. ( currently reside in Florida) thank you very much.
( this is not chylous per doctor)
please.. can you send me names of any type of doctor who may specialize in this. I am willing to go anywhere in the world at this point. ( currently reside in Florida) thank you very much.
Brief Answer:
Needs work up and management
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. Ascitic fluid with no underlying metabolic or liver causes should be evaluated for malignancies of peritoneum and other viscera, ovarian malignancies . YOur ascitic fluid needs to be analysed, quantify the ingredients in it like exudative or transudative and then work it up for any atypical cells in it to suspect malignancies. Also blood markers and thorough gynecological work up needs to be done. A detailed clinical correlation to sort out all possible causes for portal hypertension, low albumin, congestive heart failure, renal failure etc needs to be ruled out. Visit a good physician and let them help you further in this regard.
I hope it helps. Take good care of yourself and dont forget to close the discussion please.
Regards
Khan
Needs work up and management
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. Ascitic fluid with no underlying metabolic or liver causes should be evaluated for malignancies of peritoneum and other viscera, ovarian malignancies . YOur ascitic fluid needs to be analysed, quantify the ingredients in it like exudative or transudative and then work it up for any atypical cells in it to suspect malignancies. Also blood markers and thorough gynecological work up needs to be done. A detailed clinical correlation to sort out all possible causes for portal hypertension, low albumin, congestive heart failure, renal failure etc needs to be ruled out. Visit a good physician and let them help you further in this regard.
I hope it helps. Take good care of yourself and dont forget to close the discussion please.
Regards
Khan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for responding. The ascitic fluid has been tested for all the concerns you listed above. There is no malignancy. I do not have portal hypertension. I've seen a hepatologist, infectious disease doctor, vsscular surgeon, gastrointrrologist... they all say they've never seen this before and don't know what to do about it. I did NOT have this problem before my hysterectomy. The hysterectomy caused an internal bleed, which caused an infection, which caused peritonitis. I was on NSAIDS for several months. The ascites presented some time during the bleed/infection, but wasn't discovered until the peritonitis. There were lymph nodes removed during the hysterectomy (all free of any cancer), so the vascular surgeon suspected leaky lymphatics for the ascites, but is not certain. He order IR to perform a lymphangiogram which did not provide any new clues to the cause of the ascites. I need to know if there are ANY doctors out there who have ever seen and treated someone else with my unusual condition. PLEASE.
Brief Answer:
Supportive care
Detailed Answer:
Thank you for getting back to me
Your question has answers in it. With hysterectomy, peritonitis and visceral peritoneal inflammation can lead to such discomfort and ascites. With all the concerns ruled out, if the ascites is marked and significant then you need supportive care for that with diuretics, diet lifestyle adjustments, good proteinaceous diet to keep the albumins in good count.
Nutshell, with abdominal procedures done, peritonitis in history, ascites can be inevitable and good news of all the labs clear, all one needs is supportive care. rest for a special ascites specialist, hepatologists, gastroenterologists deal that. You have been tested for every possibility by the book. All you need now is supportive care and management.
I hope it helps.
Regards
Khan
Supportive care
Detailed Answer:
Thank you for getting back to me
Your question has answers in it. With hysterectomy, peritonitis and visceral peritoneal inflammation can lead to such discomfort and ascites. With all the concerns ruled out, if the ascites is marked and significant then you need supportive care for that with diuretics, diet lifestyle adjustments, good proteinaceous diet to keep the albumins in good count.
Nutshell, with abdominal procedures done, peritonitis in history, ascites can be inevitable and good news of all the labs clear, all one needs is supportive care. rest for a special ascites specialist, hepatologists, gastroenterologists deal that. You have been tested for every possibility by the book. All you need now is supportive care and management.
I hope it helps.
Regards
Khan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. What type of doctor do I ask for who can help me with supportive care? What specialty? With the supportive care, will the ascites go away so I don't have to keep getting paracentesis? Thank you.
Brief Answer:
Hepatologist and gastroenterologist
Detailed Answer:
Thank you for getting back to me
With paracentesis ascites drainage is necessary if massive ascites. Good proteinaceous diets and eye on albumin levels need to be maintained. Rest any good hepatologist or gastroenterologist can do that. I hope it helps.
Regards
Khan
Hepatologist and gastroenterologist
Detailed Answer:
Thank you for getting back to me
With paracentesis ascites drainage is necessary if massive ascites. Good proteinaceous diets and eye on albumin levels need to be maintained. Rest any good hepatologist or gastroenterologist can do that. I hope it helps.
Regards
Khan
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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