麦格综合征

　　1. The production of ascites
　　It is currently believed that the tumor itself is the main source of ascites production.
　　(1) Partial栓塞 occurs in the large vein of the ovarian tumor pedicle.
　　(2) Ovarian fibroma can form cysts and has interstitial edema, with excess fluid that can mix into the abdominal cavity.
　　(3) The torsion of the pedicle of a fibroma can cause compression of the lymphatic or vascular channels in the tumor body, leading to stasis of blood or lymph, and fluid leaking from the tumor into the abdominal cavity.
　　2. The production of pleural effusion
　　Ascites can enter the chest cavity through certain channels.
　　(1) The lymphatic vessels on the right diaphragm are abundant, the dome is located at a higher position, and the suction effect is relatively strong.
　　(2) There are several small holes in the diaphragm, and ascites directly moves into the chest cavity through these holes.

　　Some cases may be accompanied by uterine prolapse. The uterus descends from its normal position along the vagina, with the external os of the cervix reaching below the level of the ischial spines, and even the entire uterus may prolapse outside the vaginal orifice, which is called uterine prolapse. It is often accompanied by prolapse of the anterior and posterior vaginal walls. The main cause of this disease is the injury and weakness of the pelvic floor supporting tissues.

　　1. There is no significant difference in the incidence of ovarian tumors on the left and right sides. According to statistics, 1％～40％ of patients with ovarian fibroma can have concurrent ascites.

　　2. Pleural effusion can occur on the same side as the ovarian tumor or on the opposite side, with 62％ occurring on the right chest, 11％ on the left, and 24％ on both sides. Although pleural and abdominal puncture and fluid aspiration are performed repeatedly, the fluid still grows rapidly. After tumor resection, the pleural effusion and ascites disappear spontaneously.

　　3. Patients with ascites may not necessarily have concurrent pleural effusion. Some cases have only ascites without pleural effusion, or have had pleural effusion but it has subsequently disappeared.

　　4. Pleural effusion, ascites is mostly exudative fluid, but a few can present as transudative fluid with relative density (specific gravity) between 0.010～1.017. There is no relationship between the volume of fluid and the size of the tumor. However, in cases with concurrent pleural effusion and ascites, the tumors are generally larger, with a diameter usually exceeding 10cm. The amount of pleural effusion and ascites varies, and when it is large, it can cause symptoms and signs of compression. When the tumor bleeds, the ascites can become bloody.

　　5. Abdominal pain, distension, cough, chest tightness, chest pain, shortness of breath, inability to lie flat, lower limb edema, urinary incontinence, weight loss, and vaginal bleeding may occur.

　　6. Physical examination shows dullness on percussion of the lung, weakened respiratory sounds, positive signs of ascites, and the patient prefers to lie on the right side. During bimanual examination, a hard mass with the characteristics of the ovary can be palpated, which is medium in size, generally greater than 10cm, with a smooth surface, good mobility, and no tenderness.

　　7. It often occurs concurrently with solid tumors of the ovary, such as ovarian fibroma, leiomyoma, theca luteinoma, and ovarian fibroepithelial tumor.

　　The incidence of Meige syndrome in patients with ovarian fibroma is 3％～12％. The age of onset is mostly between 40～60 years old, with the minimum age being 8 years and 9 months, and the maximum reaching 88 years.
　　Prognosis: The prognosis of Meige syndrome is related to the primary tumor, and early diagnosis and treatment have a good prognosis. Ovarian fibroma is benign, and a few can undergo malignant transformation, with a malignant transformation rate of 1％～3％. The prognosis is relatively good.

　　Routine examinations include: ascites examination, laparoscopy, blood examination, immunological testing, tumor marker detection, and abdominal plain film.
　　1. The biochemical examination of ascites is mostly exudative fluid, with a clear or light yellow color, specific gravity usually between 1.010～1.017, and the cell count usually less than 400×10^6/L, with protein content usually less than 0.3g/L.

　　2. There are no abnormalities in blood and ascites tumor markers.

　　3. Ascites, examined by cytology, chromosome examination, AgNOR detection, flow cytometry, and imaging analysis, all suggest benign ascites.

　　4. The biochemical differentiation of ascites, such as specific gravity, ascites protein content, lactate dehydrogenase (LDH), and the ratio of ascites-serum LDH (ASLR), adenosine deaminase (ADA), ferritin (FA), and the ratio of ascites-serum ferritin, all suggest benign ascites.

　　5. Ascites immunological detection such as CA125, β-microglobulin, etc., to distinguish the nature of ascites.

　　6. Abdominal ultrasound examination can show a moderate or enhanced echo area on one side of the adnexa, with a relatively uniform texture, moderate size, without clear cyst wall, and fluid dark area in the pelvic or abdominal cavity.

　　7. X-ray examination can also show calcified areas in fibroids, and pleural effusion also has X-ray signs.

　　8. Laparoscopic examination.

　　9. Histopathological examination.

　　Dietary precautions:
　　1. Eat more fresh vegetables, fruits, milk, and eggs to supplement protein and various vitamins.
　　2. Eat more foods that nourish the body and regulate the menstrual cycle after surgery:
　　Mandarin, longan, pomegranate, mulberry, black fungus, black sesame, mung bean, placenta, crucian carp, carp.
　　3. Eat more foods that have anti-external genital tumor effects:
　　Wheat, barley, sesame seeds, almonds, loofah, black snake, black chicken, cuttlefish, pork pancreas, chrysanthemum, umeboshi, peach, lychee, purslane, chicken blood, crab, jellyfish, eel, abalone, sardine, clam, tortoise shell.
　　4. Eat more foods that enhance immunity:
　　Black fish, shark, turtle, sea turtle, sandworm, white flower snake, water snake, shrimp, crucian carp, mulberry, fig, lychee, walnut, loofah, black bean paste, olive, purslane, almond, loofah.
　　5. Avoid foods such as pork, greasy, fried, moldy, and preserved: sesame seeds, almonds, loofah, etc.
　　6. Avoid stimulant drinks: coffee, etc.
　　7. Avoid spicy and刺激性 food: scallions, garlic, ginger, cinnamon, etc.
　　8. Abstain from smoking and alcohol.

　　1. Surgical treatment
　　Tumor resection and unilateral adnexectomy are sufficient. If the patient is older and there is a suspicion of malignancy, total hysterectomy and bilateral adnexectomy can be performed.
　　After surgery, pleural effusion and ascites disappear immediately, and symptoms and signs also diminish and disappear.
　　2. Symptomatic treatment
　　When there are symptoms of compression due to excessive pleural effusion and ascites, diuretics or puncture and fluid drainage can be used.
　　At the same time, correct the large loss of protein and the disorder of water and electrolytes.