Assessment of lipid profile of peritoneal fluid for differential ascites diagnostics

Abstract

The problem of differential ascites diagnostics in different patients remains urgent for modern surgery. Apart from well known methods, authors propose an original algorithm for assessment of ascetic fluid. The main element of such studies is the determination of a lipid spectrum of ascetic fluid and content of lipid components in cell structures. 260 samples were examined which were obtained from patients having examination and treatment in the General Surgery Clinic of the Kirov Military Medical Academy (St. Petersburg). For examination of ascetic fluid, the methods of cytological analysis of ascitic fluid centrifugate were used, its cytochemical examination, as well a complex of biochemical methods: determination of the total protein, amylase, chylomicrons, triglycerides; bacterial inoculation was made. It has been shown that the ratio of chylomicrons, lipoproteins and cytosis permits a more precise differentiation of ascites type which influences the selection of further treatment program especially in chyloperitoneum and lymphatic ascites.

Keywords

ascites / chylomicrons / lipoproteins / chyle peritonitis

References

[1] 1.Podyimova SD. Bolezni pecheni: rukovodstvo 4-e izd., pererab. i dop [Diseases of the liv-er: guide. 4th ed., pererab. and additional]. Moscow: Medcine; 2005. 768 p. (in Russian)

[2] 1.Подымова С. Д. Болезни печени: руководство. 4-е изд., перераб. и доп. М.: Медицина, 2005. 768 с.

[3] 2.Arroyo V, Ginеs P, Rodеs J, Schrier RW. Ascites and renal dysfunction in liver disease: pathogenesis, diagnosis, and treatment. Malden, Mass.: Blackwell Science. 2005.

[4] 2.Arroyo V., Ginеs P., Rodеs J., Schrier R.W. Ascites and renal dysfunction in liver disease: pathogenesis, diagnosis, and treatment. Malden, Mass.: Blackwell Science, 2005. 450 р.

[5] 3.Fuger K. Aszites. In: Differenzial diagnose internistischer Erkrankunger nach Leitsymp-tomes. Hrsg. Aufl. Munchen-Jena: Urban & Fischer; 2003. р. 63-80.

[6] 3.Fuger K. Aszites. In: Differenzial diagnose internistischer Erkrankunger nach Leitsymptomes Hrsg. Aufl. Munchen-Jena: Urban & Fischer, 2003. S. 63-80.

[7] 4.Glickman R. M. Abdominal swelling and ascites. In: Harrison’s Principles of Internal Medicine. New York: McGraw-Hill Med. Publ. Div; 2005. Р. 243-6.

[8] 4.Glickman R. M. Abdominal swelling and ascites. In.: Harrison’s Principles of Internal Medicine. New York: McGraw-Hill Med. Publ. Div., 2005. Р. 243-246.

[9] 5.Gerbes AL, Gülberg V, Wiest R, Sauerbruch T, Gerbes A.; German Society for Digestive and Metabolic Diseases (DGVS) Diagnosis and treatment of ascites, spontaneous bacterial perito-nitis, and hepatorenal syndrome in cirrhosis: S3-guideline. 2010. Р. 43-56.

[10] 5.Gerbes A.L., Gülberg V., Wiest R., Sauerbruch T. Diagnosis and treatment of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis: S3-guideline / German Society for Digestive and Metabolic Diseases (DGVS). 2010. Р. 43-56.

[11] 6.Moore K. Guidelines on the management of ascites in cirrhosis. Gut. 2006; 55: 1-12.

[12] 6.Moore K. Guidelines on the management of ascites in cirrhosis // Gut. 2006. Vol. 55. Р. 1-12.

[13] 7.Gulov MK, Kalmyikov EL, Zardakov SM, Muhabbatov DK, Sadriev ON. Ehinokokkoz pecheni: rol kompyuternoy tomografii i morfologicheskoy diagnostiki sostoyaniya tkani pecheni [Echinococcosis of the liver: the role of computed tomography and morphological diagnosis of liver tissue]. Rossijskij mediko-biologicheskij vestnik imeni akademika I.P. Pavlova [I.P. Pavlov Russian Medical Biological Herald]. 2016; 4: 104-11. (in Russian)

[14] 7.Гулов М.К., Калмыков Е.Л., Зардаков С.М., Мухаббатов Д.К., Садриев О.Н. Эхинококкоз печени: роль компьютерной томографии и морфологической диагностики состояния ткани печени // Российский медико-биологический вестник имени академика И.П. Павлова. 2016. №4. С. 104-111.

[15] 8.Andreeva IV, Vinogradov AA. Perspektivyi ispolzovaniya sovremennyih metodov vi-zualizatsii v morfologicheskih i eksperimentalnyih issledovaniyah [Prospects of using modern im-aging methods in morphological and experimental studies]. Nauka molodykh (Eruditio juvenium) [Science of young (Eruditio Juvenium)]. 2015; 4: 56-69. (in Russian)

[16] 8.Андреева И.В., Виноградов А.А. Перспективы использования современных методов визуализации в морфологических и экспериментальных исследованиях // Наука молодых (Eruditio Juvenium). 2015. №4. С. 56-69.

[17] 9.Sarkisov DS, Perov YuL., red. Mikroskopicheskaya texnika: rukovodstvo dlya vrachej i laborantov [Microscopic technology: a guide for doctors and laboratory technicians]. Moscow: Medcine; 1996. 544 p. (in Russian)

[18] 9.Микроскопическая техника: руководство для врачей и лаборантов / под ред. Д.С. Саркисова, Ю.Л. Перова. М.: Медицина, 1996. 544 c.

[19] 10.Nazyirov FG, Horoshaev VA, Devyatov AV. Osobennosti portalno-limfaticheskoy gi-pertenzii i hirurgicheskoe lechenie bolnyih tsirrozom pecheni s rezisientnyim astsitom [Features of portal-lymphatic hypertension and surgical treatment of patients with cirrhosis of the liver with resistant ascites]. Vestn. hirurgii im. I.I. Grekova [Herald surgery them I.I. Grekova]. 1999; 142 (2): 104-6. (in Russian)

[20] 10.Назыров Ф.Г., Хорошаев В.А., Девятов А.В. Особенности портально-лимфатической гипертензии и хирургическое лечение больных циррозом печени с резистентным асцитом // Вестн. хирургии им. И.И. Грекова. 1999. Т. 142, №2. С. 104-106.

[21] 11.Sedova TN. Hiloreya kak sindrom zabolevaniy i povrezhdeniy limfaticheskih protokov: (Diagnostika, klinika i lechenie) [Chilorea as a syndrome of diseases and damages of lymphatic ducts: (diagnosis, clinic and treatment)]: dis. doct. (Med. Sci.). Moscow; 1997. (in Russian)

[22] 11.Седова Т.Н. Хилорея как синдром заболеваний и повреждений лимфатических протоков: (диагностика, клиника и лечение): автореф. дис. … д-ра мед. наук. М., 1997. 26 с.

[23] 12.Rector W. Spontaneous chylous ascites of cirrhosis. J. Clin. Gastroenterol. 1984; 6: 369-72.

[24] 12.Rector W. Spontaneous chylous ascites of cirrhosis // J. Clin. Gastroenterol. 1984. Vol. 6. Р. 369-372.

[25] 13.Kaas R, Rustman LD, Zoetmulder FA. Chylous ascites after oncological abdominal surgery: incidence and treatment. Eur. J. Surg. Oncol. 2001; 27: 187-9.

[26] 13.Kaas R., Rustman L.D., Zoetmulder F.A. Chylous ascites after oncological abdominal surgery: incidence and treatment // Eur. J. Surg. Oncol. 2001. Vol. 27. P. 187-189.

[27] 14.Aalami OO, Allen DB, Organ CH. Chylous ascites: a collective review. Surgery. 2000; 128: 761-78.

[28] 14.Aalami O.O., Allen D.B., Organ C.H. Chylous ascites: a collective review // Surgery. 2000. Vol. 128. P. 761-778.

[29] 15.Chichetka AA, Biryukova LN. Hileznyiy peritonit, simuli-rovavshiy ostryiy appenditsit [Chileous peritonitis, simulating acute appendicitis]. Vestn. hirurgii im. I.I. Grekova [Herald sur-gery them I.I. Grekova]. 1991; 2: 44. (in Russian)

[30] 15.Чичетка А.А., Бирюкова Л.Н. Хилезный перитонит, симулировавший острый аппендицит // Вестн. хирургии им. И.И. Грекова . 1991. №2. С. 44.

[31] 16.Markov IA. Hileznyiy peritonit [Chylious peritonitis]. Med. zhurn. Chuvashii [Medical Journal of Chuvashia]. 1995; 3-4: 98-9. (in Russian)

[32] 16.Марков И.А. Хилезный перитонит // Мед. журн. Чувашии. 1995. №3-4. С. 98-99.

RIGHTS & PERMISSIONS

Ivanusa S.Y., Onnitsev I.E., Yankovsky A.V., Deev R.V.