A 60-year-old female patient presented to our clinic with complaints of abdominal distention. The rapid accumulation of fluid was originally thought to be ascites, based on ultrasonographic examination. The cause, however, was ultimately determined to be a borderline malignant giant ovarian cyst. Several processes can mimick ascites: bladder distention or diverticulum, hydronephrosis, pancreatic pseudocysts, and large uterine or ovarian tumors. For this reason, clinicians must consider processes other than ascites in the differential diagnosis of large abodominal fluid accumulation.
Key words. Ovarian cysts; ascites; abdomen. (J Fam Pract 1994; 39:479-481)
Ascites is one of the common causes considered in the differential diagnosis of abdominal distention related to the accumulation of a large quantity of fluid. Common causes of transudative ascites are liver cirrhosis and heart failure. Less common reasons are constrictive pericarditis, inferior vena cava or hepatic vein occlusion, and liver neoplasms. When the ascitic fluid is exudative, the differential diagnosis includes tuberculosis, pancreatitis, primary or secondary peritonitis due to bile fluid, pelvic inflammatory disease, ruptured viscus and liver or peritoneal metastases. Other causative origins may include hypothyroidism, endometriosis, collagen diseases, hypoalbuminemia, Meig's syndrome, pseudomyxoma peritonei, and leakage of the cysterna chyli or other lymphatic vessels.(1)
Processes mimicking ascites, such as bladder distention, or diverticulum, hydronephrosis, pseudocyst of the pancreas, or large tumors of the ovaries or uterus, must also be considered.(2)
We describe a patient with a rapid accumulation of fluid originally diagnosed as ascites by ultrasonographic examination, but which ultimately proved to be a borderline malignant giant ovarian cyst.
A 60-year-old woman came to our clinic over a period of 4 months with complaints of abdominal distention, poor appetite, weight loss, and constipation that she had been experiencing over the course of a year (Figure 1). Her history was significant only for hypertension, for which she was taking medications. Physical examination revealed cachexia without fever or shortness of breath. Her blood pressure was 170/100 mm Hg, and her pulse...