Résumé
L’ascite est un symptôme fréquemment rencontré au service d’urgence. Au travers d’un cas clinique d’ascite infectée de présentation et d’étiologie inhabituelle (infection à Listeria monocytogenes), nous présentons les principaux critères décisionnels de la prise en charge des ascites en situation d’urgence. La démarche syndromique nécessite de prendre en compte avec discernement les comorbidités, les arguments cliniques et complémentaires disponibles. La ponction d’ascite exploratrice occupe une place essentielle pour définir la démarche thérapeutique adéquate. Dans ce cadre, l’échographie d’urgence pour le repérage peut être d’une aide précieuse.
Abstract
Ascitis is a common complaint of patients presenting to emergency department. Hereafter, based on the case report of a patient with an infected ascitis of unsual presentation and etiology (Listeria monocytogenes infection), we highlight the main criteria for guiding medical management in the emergency setting. An adequate diagnostic strategy should include an accurate review of patient comorbid conditions and all available clinical and laboratory findings. Information stems from ascitis fluid analyses is mostly valuable altogether. In this perspective, performance of ultrasound echography at bedside to locate intra-abdominal fluid collection and to guide paracentesis is of great interest.
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Santin, A., Roux, M. & Renaud, B. Ascite, démarche diagnostique et étiologique : un cas clinique. Ann. Fr. Med. Urgence 2, 335–338 (2012). https://doi.org/10.1007/s13341-012-0195-8
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DOI: https://doi.org/10.1007/s13341-012-0195-8