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Ascites is well-documented sequelae of liver cirrhosis with significant impact on survival in this group of patients. Among the many established management strategies for the same is the use of an implantable mechanical device, called alfapump (Sequana Medical, Zurich, Switzerland), that removes ascitic fluid by pumping it from the peritoneal cavity to the urinary bladder. Until recently, this device has been surgically placed under general anaesthesia. We describe successful interventional radiological implantation under conscious sedation in three patients with minimal complications. This device can serve as an alternative to transjugular intrahepatic portosystemic shunt for the management of refractory ascites; however, further studies are required to understand the device better.
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http://dx.doi.org/10.1259/bjrcr.20170025 | DOI Listing |
Cureus
August 2025
Interventional Radiology, Sacred Heart Hospital, Pensacola, USA.
Transjugular intrahepatic portosystemic shunt (TIPS) placement is a well-established intervention for portal hypertension. However, some patients experience persistent complications such as encephalopathy, ascites, or thrombocytopenia, especially when further TIPS optimization is not technically possible. Partial splenic embolization (PSE), typically performed for hypersplenism or certain hematologic conditions, can reduce portal venous inflow and improve cytopenias; however, its use as an adjunct to TIPS is less well described.
View Article and Find Full Text PDFPurpose Of The Review: To review epidemiology, pathogenesis, diagnosis, and management of hepatic hydrothorax.
Recent Findings: Refractory hepatic hydrothorax is an independent predictor of mortality in patients with decompensated cirrhosis. Allocation of Model for End-Stage Liver Disease exception points for patients with refractory hydrothorax was found to be associated with a significant reduction in post liver transplant mortality.
Heart Fail Rev
September 2025
Department of Medicine, Division of Cardiology, University of Texas Medical Branch, Galveston, TX, USA.
Hypoalbuminemia is commonly seen in patients with heart failure and is associated with worse outcomes. Multiple pathophysiologic mechanisms can contribute to low albumin levels in heart failure patients, such as malnutrition, hepatic congestion, inflammation, and protein-losing enteropathy. Hypoalbuminemia can exacerbate heart failure symptoms and contributes to pulmonary edema by reducing plasma oncotic pressure, thereby favoring fluid movement into the interstitial and alveolar spaces.
View Article and Find Full Text PDFAnn Med Surg (Lond)
September 2025
Vinmec Times City International Hospital, Hanoi, Vietnam.
Introduction And Importance: Chylous ascites is an exceptionally rare condition during pregnancy, typically presenting with nonspecific symptoms. To date, only a limited number of cases have been reported in the literature, and the majority of which occurred in singleton pregnancies.
Case Presentation: We report the case of a 25-year-old woman with a twin pregnancy who was admitted at 32 weeks of gestation with acute abdominal pain and nausea.