Introduction. Calcium channel blockers (CCBs) are commonly used agents in the treatment of hypertension as part of monotherapy or combination therapy. Peripheral edema is the most common side effect that requires discontinuation or replacement of treatment. Some studies in the literature have shown that long-acting dihydropyridine type CCBs lead chylous ASCITES in peritoneal dialysis patients. However, amlodipine-associated serous ASCITES cases are not available in the literature. Case Report. In this case report, we describe a rare case of amlodipine induced massive ASCITES in a 30-year-old male with renal transplantation. Conclusion. We aimed to create awareness that pharmacologic causes should be considered in cases of ASCITES of unknown aetiology.

Idiopathic chylous ASCITES in pregnancy is extremely rare. Here, we report a 24-yr-old patient with idiopathic chylous ASCITES in pregnancy. The patient was hospitalized in Xiamen Maternity and Child Health Care Hospital, Xiamen China in 2014 due to G1P0 intrauterine pregnancy 39+2 week, LOA, and time of labor. The patient gave birth to a live baby boy (3. 6 kg) by spontaneous vaginal delivery, with complete delivery of placenta. Three hours after delivery, the patient reported abdominal distension and pain, as well as asthma. Later, milky white liquid was drawn from left lower abdomen by puncture. Exploratory laparotomy was performed, and 800 ml milky white liquid was drawn from the abdominal cavity. Subsequently, drainage tube was placed in the ab-dominal cavity, and the abdomen was closed. After the surgery, the patient was given low-fat diet, supplemented with parenteral nutrition support and intravenous injection of antibiotics. Extubation was performed on day 3. On day 7 after surgery, the mother and baby left the hospital without any health problems. No abnormality was observed during six months of follow-ups. Idiopathic chylous ASCITES in pregnancy may be related to congenital lymphatic system dysplasia, and directly caused by chylous flow from ducts into abdominal cavity induced by progesterone during pregnancy or pressure from enlarged uterus during late pregnancy. After pregnancy, the disease is cured by the release of disease cause and the reduction of thoracic duct pressure.

Massive post-transplantation ASCITES is a rare but serious condition following liver transplantation. Although, many etiologies are suggested as the cause of this complication, in some cases the definitive etiology remains unknown. Drug-induced post-transplantation ASCITES is one of the possible etiologies. In this study we present a case of ASCITES caused by tacrolimus in the post-liver transplantation period. A 49-year-old man with hepatitis B virus cirrhosis underwent liver transplantation and received tacrolimus, mycophenolate and prednisolone, as the immunosuppressive regimen. Progressive ASCITES developed after 10 days, in spite of a normal liver function. Various studies, including liver biopsy, were performed but we could not find any etiology for this complication. The tacrolimus was switched to rapamune. ASCITES was completely disappeared and up to the last follow-up visit, the patient remained asymptomatic for more than two years. We concluded that after ruling out other etiologies, tacrolimus as a rare cause of post-transplantation ASCITES should be taken into account. The treatment is discontinuation of the drug.

Cerebrospinal fluid (CSF) ASCITES is a rare complication after ventriculopritoneal (VP) shunts. Most patients have gradual abdominal protrusion without any neurological sign or symptom of shunt malfunction. We presented a girl with posterior third ventricle glioblastoma and acute hydrocephalus who developed increasingly abdominal protrusion one month after VP shunt operation. ASCITES fluid examination showed characteristic findings similar to CSF with no evidence of infection or malignant cells. Ventriculo-atrial shunt revision cured patient's ASCITES. Review articles of patients with CSF ASCITES after VP shunt were presented in details.