RESUMO
BACKGROUND AND OBJECTIVE: Ascites complicates many advanced malignancies, resulting in abdominal pain, discomfort, anorexia, nausea, and dyspnea. Percutaneous drainage relieves symptoms in the vast majority of patients. The aim of this study was to determine the course and outcomes in a consecutive series of patients with recurrent ascites managed with permanent peritoneal ports. METHODS: A prospective longitudinal descriptive study from 2006 to 2011, involving patients treated at the Sydney Cancer Center (New South Wales, Australia). RESULTS AND CONCLUSIONS: A total of 155 drainages were performed in 24 patients; 26% of drainages (n=40) in the patient's home and the remainder in the ambulatory care clinic. Grade 3 or higher adverse events occured in less than 25% of all draining procedures. An improvement in symptoms was demonstrated in almost half of all individual drainage procedures. Our findings suggest that peritoneal ports are efficacious, safe, and are associated with symptomatic relief in most patients.
Assuntos
Ascite/terapia , Neoplasias/complicações , Cuidados Paliativos/métodos , Paracentese/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ascite/complicações , Ascite/etiologia , Institutos de Câncer , Cateteres de Demora/efeitos adversos , Cateteres de Demora/normas , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , New South Wales , Paracentese/efeitos adversos , Paracentese/instrumentação , Estudos Prospectivos , Recidiva , Resultado do Tratamento , Adulto JovemRESUMO
Malignant pheochromocytoma is a rare disorder. We describe the case of a 41-year-old female with disseminated metastatic pheochromocytoma who was admitted for ongoing palliative and supportive care within an inpatient palliative care unit. Predominant symptoms included severe gastrointestinal pseudo-obstruction and orthostatic hypotension Pseudo-obstruction management included percutaneous enterogastric and percutaneous enterojejunostomy tubes for gastric decompression and delivery of nutrition, respectively. Debilitating symptoms of orthostatic hypotension were mitigated with judicious fluid balance and appropriate use of adrenergic blocking agents. The potential for metoclopramide to worsen symptoms also was a significant component of management. The case presents rare features of this unusual disease and is unique for its setting within the confines of a palliative care unit.