Hemorrhagic ascites as a complication of heart failure: A case report and review of the literature

Introduction:

Although ascites is a common complication of congestive heart failure, the association between heart failure and hemorrhagic ascites is quite rare.

Patient concerns:

A 64-year-old woman with recurrent large bloody ascites secondary to heart failure.

Diagnosis:

Ascitic fluid assessment revealed red blood cells of 75,125/mm3 and white blood cells of 225/mm3. The total protein in the ascitic fluid was 28.7 g/L, with a high serum ascites albumin gradient. Peritoneal fluid examinations for bacterial culture, acid-fast bacilli (smear and culture), and malignant cell cytology were negative.

Interventions:

The patient was managed with therapeutic paracentesis, aggressive diuresis, and optimization of her heart failure medications.

Outcomes:

The patient’s symptoms improved dramatically and was discharged in a stable condition.

Conclusion:

Congestive heart failure should be considered as a potential cause of hemorrhagic ascites after ruling out other serious causes.

Other Information

Published in: Medicine
License: http://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://dx.doi.org/10.1097/md.0000000000030708