SHM Converge Scientific Abstract ePoster Gallery-A Case of Colorectal Adenocarinoma and the Imporance of Diagnostic Paracentesis

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This case emphasizes the importance of diagnostic paracentesis in patients with ascites, especially when there is risk for malignancy. While ascites is most commonly associated with portal hypertension and liver cirrhosis in the United States, malignant ascites must also be considered, since it may be mistaken for cirrhosis-related fluid accumulation. In some patients, an underlying cancer may be the true cause of ascites and can account for a meaningful minority of cases.<br /><br />The patient was found to have imaging findings concerning for malignancy. CT of the abdomen and pelvis with contrast showed soft tissue fullness in the sigmoid colon consistent with a colonic neoplasm, moderate ascites, and probable omental caking. Colonoscopy identified a mass in the sigmoid colon, and biopsy confirmed poorly differentiated colorectal adenocarcinoma with signet ring cell morphologic features.<br /><br />The report highlights that malignant ascites is caused by cancer-related fluid accumulation in the peritoneal cavity and often indicates advanced disease. Prognosis depends on the primary cancer type, ascites volume, performance status, and response to treatment.<br /><br />Overall, this case reinforces that ascitic fluid analysis should not be overlooked. Diagnostic paracentesis can help distinguish malignant ascites from benign causes, allowing for earlier cancer detection, appropriate staging, and timely treatment.

Asset Subtitle

Chidozie B. Igbonagwam

Meta Tag

Author List Adriana Morales Rivera, Chidozie B. Igbonagwam, Lauren Martinez, Omar Zuhdi, Paola Campillo, Zein Barakat

Category Clinical Vignettes

Concept Cirrhotic Ascites

Concept Diagnostic Paracentesis

Concept Malignant Ascites

Concept Portal Hypertension

Concept Cirrhosis

Distinguished Non-Finalist

Presenter Organization Lakeland Regional Health

Presenting Author Chidozie B. Igbonagwam

Track Adult

Keywords

diagnostic paracentesis

ascites

malignant ascites

colorectal adenocarcinoma

sigmoid colon mass

peritoneal cavity

omental caking

colonoscopy

biopsy

cancer staging

Cirrhotic Ascites

Diagnostic Paracentesis

Malignant Ascites

Portal Hypertension

Cirrhosis