Pseudomyxoma Peritonei-An Unusual Cause of Ascites: A Case Report

Perm J. 2019;23:18-114. doi: 10.7812/TPP/18-114. Epub 2019 Jun 24.


Introduction: Ascites in patients with cardiac disease can be multifactorial. Serum ascitic albumin gradient (SAAG) helps in identifying the etiology of ascites. High SAAG ascites is related to hepatic or posthepatic causes. The causes of low SAAG ascites results include tuberculosis, peritoneal malignancy, or pancreatitis.

Case presentation: We report an unusual cause of low SAAG ascites in a 48-year-old woman with valvular heart disease. The patient presented with ascites, and cross-sectional imaging revealed a right iliac fossa mass with omental deposits. The patient was finally diagnosed as having pseudomyxoma peritonei on the basis of clinicoradiopathological features.

Discussion: Pseudomyxoma peritonei is a rare cause of low SAAG ascites. It is characterized by the deposition of mucinous material on the peritoneal surfaces. The most common site of origin is the appendix, although it can arise from other intraabdominal organs as well. Excision of the tumor combined with intraperitoneal chemotherapy is the preferred modality of treatment.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma, Mucinous / complications
  • Adenocarcinoma, Mucinous / diagnostic imaging
  • Appendiceal Neoplasms / complications
  • Appendiceal Neoplasms / diagnostic imaging
  • Ascites / diagnostic imaging
  • Ascites / etiology*
  • Biomarkers / analysis
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Humans
  • Middle Aged
  • Pseudomyxoma Peritonei / complications*
  • Pseudomyxoma Peritonei / diagnostic imaging
  • Serum Albumin / analysis
  • Tomography, X-Ray Computed


  • Biomarkers
  • Contrast Media
  • Serum Albumin