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CASE REPORT
Year : 2014  |  Volume : 6  |  Issue : 7  |  Page : 346-348

Extensive loculated ascites in hepatic amyloidosis


1 Department of Internal Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA
2 Bassett Medical Center, Columbia University, New York, USA

Correspondence Address:
Saranya Buppajarntham
Department of Internal Medicine, Albert Einstein Medical Center, 5501 Old York Road, Philadelphia, Pennsylvania 19141
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1947-2714.136923

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Context: Amyloidosis is a disease of extracellular deposition of misfolded proteinaceous subunits, which could be systemic or localized disease. Though hepatic amyloidosis was not uncommon in autopsy series, most cases of hepatic amyloidosis were asymptomatic. Ascites, jaundice, portal hypertension, and gastrointestinal bleeding from esophageal varices were reported in literature. Case report: A 42-year-old man with end-stage renal disease on hemodialysis and recent small bowel obstruction presented with chronic abdominal pain. Computed tomography of abdomen and pelvis showed extensive loculated ascites and multiple small bowel loops tethered to adhesions and hepatomegaly. Finally, hepatic venography and liver biopsy confirmed hepatic amyloidosis with portal hypertension. The patient was waiting for liver transplant for definite treatment. Conclusion: We report a rare case of hepatic amyloidosis with prior small bowel obstruction presented with extensive loculated ascites and multiple small bowel loops tethered to adhesions.


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