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Monday, January 02, 2012

ASCITES due to PANCREATITIS with HIGHLY ELEVATED CA-125 , Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

BOY 15 YO WITH ABDOMEN DISTENTION FOR 01 MONTH. DISCHARGED FROM A LOCAL HOSPITAL WITH SUSPICION OF PERITONEUM CANCER.


ULTRASOUND AT MEDIC DETECTS A BIG AMOUNT OF ASCITES, NO CARDIO- PLEURAL EFFUSION, LIVER, KIDNEY ARE NORMAL AND NO ABDOMINAL MASS. ASCITES IS IN CLOUDY APPEARANCE.


It is free ascites no septation, mesentery moving freely in the fluid.



ABDOMEN TAP: ASCITES IS YELLOW IN COLOR. ANALYSIS IS.. POSITIVE RIVALTA, ADA=16,3 UI/L, CA-125 MORE >1000U/mL.


BLOOD TESTS: ANA, LE-CELL NEGATIVE, BLOOD CA-125=583 UI/mL.

THIS CASE WAS ADMITED IN  EMERGENCY BY CHILDREN n0.1 HOSPITAL.

CT SCAN OF ABDOMEN SHOWED DILATATION OF WIRSUNG DUCT, SUSPECTING
PANCREATITIS,  AND CONFIRMED BY VERY HIGH BLOOD AMYLASE TEST.


SUMMARY: DIAGNOSING OF ASCITES MUST FOLLOW THE GUIDING CHART OF CHECK
LIST. A RARE CAUSE OF ASCITES  LOOKS LIKE CHRONIC PANCREATITIS IS EASILY DIAGNOSIS IF AMYLASE IN LIST FOR ANALYSING.

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