[Diagnosis and treatment of hydropic-ascitic syndrome in patients with bowel pathology]

The lecture outlines the pathogenesis, clinic characteristics, diagnosis and treatment of hydropic-ascitic syndrome (HAS) associated with the violation of absorption and exudation of protein in the small intestine. At absorption violation in patients we can find not only HAS also we can find there chronic diarrhea, violation of trophics. Increased exudation of plasma protein in bowel lumen develops at inherent violation of patency of lymph vessels (limfangiektase), blockade of lymphatic apparatus of the intestines, with tuberculosis, amyloidosis, sarcoidosis, retroperitonealnom fibrosis, endometriosis, Uippl disease and tumor infiltration of lymphatic system and mesentery. Secondary enteropatiya with protein loss (EPL) is possible in patients with constrictiv perikardite and right ventricular failure of various etiology. Establishment of correct diagnosis with the help of HAS enterogene biopsy of small intestine mucosa, coloring amyloid in biopsy sampling and PAS-positive inclusions, immunological tests for celiac disease and heavy chains - alpha. In patients with chronic diarrhea and malabsorption symptoms most likely cause of the HAS is celiac. In the absence of data for celiac disease should be kept in mind the small bowel disease chronic lymphoproliferative diseases. Treatment depends on basic disease. Good effect of providing enteral nutrition. Disorders of water-electrolyte exchange eliminates intravenous glucose-electrolyte solutions. The main method of removing gipoproteinemy when EPL was prolonged intravenous proteincontents solutions and temporary use of corticosteroids.