PSEUDOASCITES, WHAT WE CAN LEARN FROM PUBLISHED CASE REPORTS AND SERIES

Ioannis Vrettos*, Panagiota Voukelatou, Apostolos Katsoras, Despoina Theotoka and Andreas Kalliakmanis

ABSTRACT

For patients with abdominal distension but without free peritoneal fluid, that give the false impression of ascites the term pseudoascites is used. The aim of this review is to summarize the published cases of pseudoascites in order to enrich our knowledge about the etiology of this condition and to avoid futile invasive diagnostic procedures. We searched MEDLINE, for any type of giant abdominal cystic lesion mistaken for ascites. We also perused the references of the retrieved articles to identify reports that may have been missed by the electronic searches. Totally we identified 42, relevant to the study topic articles that included 49 cases (29 males) between 15 months -92 years old. The most frequent diagnoses were omental and ovarian cyst. As it seems from the published cases of pseudoascites, the differential diagnosis from ascites cannot be based only on history and clinical examination. All patients should undergo an abdominal ultrasonography and in doubtful cases a computed tomography or a magnetic resonance imaging of the abdomen should be performed. If the imaging studies do not reveal typical signs of free fluid, the patients (which ultimately are few) should undergo an exploratory laparotomy instead of an abdominal paracentesis, which could have disastrous consequences.

Keywords: Pseudoascites, ascites, abdominal cyst.