PMC3108789_01
A) A paracentesis pigtail catheter was inserted into the abdominal cavity to draw out the ascites into the arterial chamber to be mixed with the blood by the flow control roller pump (pump B) during hemodialysis. This procedure allows for control of the flow of ascite reinfusion by the flow control roller pump (pump B) and the amount of body fluid removal by the ultrafiltration rate of the dialyzer simultaneously. B) The abdomen was distended by massive ascites. The superficial veins were also engorged before continuous infusion of ascites into the dialyzer to mix with blood. C) After ascite removal by ascite reinfusion into dialyzer, the distended abdomen and engorged veins disappeared.. Abbreviations: H. pump, heparin pump; IV. set, intravenous set; A. Ch, arterial chamber; As. Ch, ascites chamber; V. Ch, venous chamber.
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The mixed blood and ascites were then channeled into the systemic circulation during a 4-hour HD session (Figure 1A).
A) Contrast-enhanced CT of abdomen revealed massive ascites. B) Contrast-enhanced CT taken after modified hemodialysis for 10 days. The scan at the same level as (A) reveals the disappearance of ascites.. Abbreviation: CT, computed tomography.
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The abdominal computed tomography scan revealed massive ascites (Figure 2A).
The changes in body weight, abdominal girdle, and serum albumin after seven sessions of continuous infusion of ascites into the dialyzer during hemodialysis over 9 days.. Abbreviation: BW, body weight; HD, hemodialysis.
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The body weight and abdominal girth decreased from 50.2 kg to 37 kg and from 92 cm to 72 cm, respectively (Figure 3). The serum albumin level increased from 30 to 35 g/L (Figure 3).
An omentum biopsy shows chronic inflammatory cell infiltration and congestion.
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The pathologic finding of the omentum was chronic inflammation with cell infiltration, congestion, and fibrosis (Figure 4).