Palliation of malignant ascites with a Tenckhoff catheter

Our plain-English summary of Palliation of malignant ascites with a Tenckhoff catheter, by D.A. Lomas, P.J. Wallis, R.A. Stockley (Thorax, 1989).

The study

• Authors: D.A. Lomas, P.J. Wallis, R.A. Stockley
• Journal: Thorax
• Published: 1989;44(10):828
• Type of article: Case report
• Cited by: 18 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

To avoid multiple paracenteses, a Tenckhoff catheter was used successfully to drain the ascitic fluid in a patient with peritoneal mesothelioma.

In plain English

This was a case report of one patient from the General Hospital, Birmingham. A 60-year-old man had a month of growing abdominal swelling and a painful, swollen right scrotum. For 20 years he had sprayed blue asbestos onto the bodywork of buses and trains, and his exposure was described as heavy. His chest X-ray showed calcified pleural thickening consistent with asbestos-related pleural plaques. A biopsy of a deposit near his navel and tests of his abdominal fluid were consistent with malignant mesothelioma. Diuretic drugs did not control the fluid build-up (ascites), so a Tenckhoff catheter, a drainage tube, was placed. Eighteen litres drained in the first seven days, and his symptoms improved quickly. At home, draining 1 litre a day kept the ascites and discomfort controlled. His blood albumin fell from 28 g/l to 18 g/l, and the authors said the drainage may have contributed. He died three months after presentation. Autopsy found diffuse mesothelioma of the peritoneum (abdominal lining). The authors recommended this treatment to relieve symptoms in patients with peritoneal malignant mesothelioma and intractable ascites.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (one patient)
• Who was studied: one 60-year-old man seen at the General Hospital, Birmingham, with abdominal swelling and a swollen right scrotum
• Exposure: heavy occupational exposure: for 20 years he sprayed blue asbestos onto bus and train bodywork in the bus and train construction industry
• Main results:
  • The chest radiograph showed pleural thickening with calcification, consistent with pleural plaques due to asbestos exposure
  • Biopsy of the umbilical deposit and cytology of the ascitic fluid were consistent with malignant mesothelioma
  • Diuretics failed to control the ascites. After the Tenckhoff catheter was inserted, 18 litres drained over the first seven days, with rapid symptom improvement and reduced scrotal swelling
  • After discharge the catheter drained 1 litre a day, controlling the ascites and abdominal discomfort
  • The patient's serum albumin fell from 28 g/l at catheter insertion to 18 g/l
  • He died three months after presentation. Necropsy showed bilateral pleural plaques and diffuse mesothelioma of the parietal and visceral peritoneum
• The authors' conclusion: The authors recommended a Tenckhoff catheter for palliation in patients with peritoneal malignant mesothelioma and intractable ascites
• Limitations the authors state:
  • The authors noted that removing the ascitic fluid may have contributed to the fall in serum albumin, although the patient was also anorexic and terminally ill

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Ascites, Peritoneal Mesothelioma.

Related studies

• The role of "closed abdomen" hyperthermic intraperitoneal chemotherapy (HIPEC) in the palliative treatment of neoplastic ascites from peritoneal carcinomatosis: report of a single-center experience — L. Orgiano, F. Pani, et al. (2016)
• Subcutaneous seeding after ultrasound-guided placement of intrapleural catheter. An unusual complication of the intracavitary palliative treatment of pleural mesothelioma — S. Sartori, I. Nielsen, et al. (1999)
• Efficacy of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in the management of malignant ascites — R.W. Randle, K.R. Swett, et al. (2014)
• "Signet-ring" cells--a caveat in the diagnosis of a diffuse peritoneal mesothelioma occurring in a lady presenting with recurrent ascites: an unusual case report — B. Rekhi, S. Pathuthara, et al. (2010)
• An unusual case of ascites: pitfalls in diagnosis of malignant peritoneal mesothelioma — J.R. Clark, W.B. Ross (2000)
• Metastatic peritoneal mesothelioma in the setting of recurrent ascites: a case report — V. Samedi, S. White, et al. (2010)

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