Severe IBD with severediffuse lyphangiectasia, omental edema and lymphangiectasia, severe 3rd spacing of fluid both in abdomin and pleural cavity due to hypoproteinemia, The small liver maybe contributing to the hypoproteinemia, maybe congenital hepatocellular or hepatomicrovascular dysplastic component. I don't detect an extrahepatic portosystemic shunt within the confines of an awake patient, small portal vasculature (dehydration & 3rd spacing) large ascites & digesta filled stomach.
procedure done... a sterile US guided abdominocenttesis & cystocentesis was performed, abdominal effusion is very clear, harvested urine appears normal in color.... Plus I got loads of ultrasound pictures they gave me, which means nothing to me when I look at them, but it was nice they gave them to me. let me know what you're thinking!! Thankyou |