Traitement palliatif de la carcinose péritonéale

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Résumé

Cet article fait le point sur le traitement palliatif des deux principaux symptômes engendrés par la carcinose péritonéale : l’ascite et l’occlusion. Il propose une stratégie thérapeutique fondée sur l’analyse de la littérature et l’expérience des équipes spécialisées en soins palliatifs. Il aborde la place respective des diurétiques, des ponctions et des drainages par cathéter intrapéritonéal pour le traitement de l’ascite. Il fait le point sur le traitement médicamenteux de l’occlusion et évalue les places respectives des traitements désobstructifs, chirurgical ou endoscopique, et des traitements de décharge par sonde nasogastrique ou par gastrostomie.

Mots clés

Ascite Occlusion intestinale Cancer abdominal Cancer pelvien Soins palliatifs 

Palliative care for peritoneal carcinomatosis

Abstract

This paper is a review of the palliative management of the 2 main symptoms of peritoneal carcinomatosis: ascites and bowel obstruction. A therapeutic strategy is proposed based on a literature review and experience acquired by teams specializing in palliative care. Various treatment methods for ascites are discussed, including diuretic therapy, paracentesis and peritoneal drainage catheter. Pharmacological therapy for bowel obstruction is reviewed and various treatment methods for bowel obstruction are discussed, including surgery, endoscopic stenting, nasogastric suction and venting gastrostomy.

Keywords

Ascites Intestinal obstruction Abdominal neoplasms Pelvic neoplasms Palliative care 
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Copyright information

© Springer Verlag France 2007

Authors and Affiliations

  1. 1.Service de médecine Ahôpital PasteurColmar cedexFrance

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