Relationship of portal hypertension to ascites in Laennec's cirrhosis

Abstract

The effect of portacaval anastomosis on the fluid and electrolyte balance of five selected patients with Laennec's cirrhosis and chronic ascites was studied. In these persons ascites disappeared following the shunt operation, although marked peripheral edema developed in several cases. These observations are presented in support of the importance of the role of portal hypertension in the formation of ascites in Laennec's cirrhosis. Portacaval anastomosis is not advocated as a general method of treating chronic ascites, although it may be beneficial in some patients. In two additional patients cited ascites made its first appearance shortly after portacaval anastomosis was established. A possible mechanism is postulated. The formation of ascitic fluid in experimental animals in whom hepatic venous pressure is elevated is also discussed. It is considered that these results apply to the formation of ascites in certain clinical conditions but do not necessarily apply in the case of Laennec's cirrhosis.