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. 1963 Jun;4(2):95–105. doi: 10.1136/gut.4.2.95

The aetiology and management of ascites in patients with hepatic cirrhosis: A review

Sheila Sherlock, Stanley Shaldon
PMCID: PMC1413422  PMID: 13977164

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Selected References

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  1. ARONOFF A., BARKUM H. Hyperuricemia and acute gouty arthritis precipitated by thiazide derivatives. Can Med Assoc J. 1961 May 27;84:1181–1186. [PMC free article] [PubMed] [Google Scholar]
  2. BAGGENSTOSS A. H., CAIN J. The hepatic hilar lymphatics of man; their relation to ascites. N Engl J Med. 1957 Mar 21;256(12):531–535. doi: 10.1056/NEJM195703212561201. [DOI] [PubMed] [Google Scholar]
  3. BARKER H. G., REEMTSMA K. The portacaval shunt operation in patients with cirrhosis and ascites. Surgery. 1960 Jul;48:142–154. [PubMed] [Google Scholar]
  4. BERMAN J. K., HULL J. E. Experimental ascites; its production and control. Surgery. 1952 Jul;32(1):67–75. [PubMed] [Google Scholar]
  5. BERSTEIN S. H., WESTON R. E., ROSS G., GROSSMAN J., HANENSON I. B., LEITER L. Studies on intravenous water diuresis and nicotine and pitressin antiduresis in normal subjects and patients with liver disease. J Clin Invest. 1953 May;32(5):422–427. doi: 10.1172/JCI102754. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. BEYER K. H., BAER J. E. Physiological basis for the action of newer diuretic agents. Pharmacol Rev. 1961 Dec;13:517–562. [PubMed] [Google Scholar]
  7. BIRCHARD W. H., PROUT T. E., WILLIAMS T. F., ROSENBAUM J. D. Diuretic responses to oral and intravenous water loads in patients with hepatic cirrhosis. J Lab Clin Med. 1956 Jul;48(1):26–35. [PubMed] [Google Scholar]
  8. BIRKENFELD L. W., LEIBMAN J., O'MEARA M. P., EDELMAN I. S. Total exchangeable sodium, total exchangeable potassium, and total body water in edematous patients with cirrhosis of the liver and congestive heart failure. J Clin Invest. 1958 May;37(5):687–698. doi: 10.1172/JCI103655. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. BLAKEMORE A. H. Portacaval shunting for portal hypertension. Surg Gynecol Obstet. 1952 Apr;94(4):443–454. [PubMed] [Google Scholar]
  10. BONGIOVANNI A. M., EISENMENGER W. J. Adrenal cortical metabolism in chronic liver disease. J Clin Endocrinol Metab. 1951 Feb;11(2):152–172. doi: 10.1210/jcem-11-2-152. [DOI] [PubMed] [Google Scholar]
  11. BURACK W. R., HOLLISTER R. M. Tuberculous peritonitis. A study of forty-seven proved cases encountered by a general medical unit in twenty-five years. Am J Med. 1960 Apr;28:510–523. doi: 10.1016/0002-9343(60)90145-5. [DOI] [PubMed] [Google Scholar]
  12. Bradley S. E., Bradley G. P. THE EFFECT OF INCREASED INTRA-ABDOMINAL PRESSURE ON RENAL FUNCTION IN MAN. J Clin Invest. 1947 Sep;26(5):1010–1022. doi: 10.1172/JCI101867. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. CATTAN R., CAROLI J., DEBRAY C., PEQUIGNOT G., VESIN P. [Possibilities and limitations of diuretic medication in liver cirrhosis with ascites and edema]. Presse Med. 1962 Feb 10;70:337–338. [PubMed] [Google Scholar]
  14. CATTAN R., VESIN P. Etat actuel du traitement des cirrhoses ascitiques par la delta-cortisone. Sem Hop. 1957 Jan 10;33(2):76–79. [PubMed] [Google Scholar]
  15. CHALMERS T. C., MORRISON R. S. Diuretic and steroid therapy in liver disease. Prog Liver Dis. 1961;1:338–350. [PubMed] [Google Scholar]
  16. CHANDLER G. N., HETHERINGTON C., STEPHENSON A. N., ATKINSON M. Potassium replacement therapy. Gut. 1961 Jun;2:186–187. doi: 10.1136/gut.2.2.186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. CHERRICK G. R., KERR D. N., READ A. E., SHERLOCK S. Colloid osmotic pressure and hydrostatic pressure relationships in the formation of ascites in hepatic cirrhosis. Clin Sci. 1960 Aug;19:361–375. [PubMed] [Google Scholar]
  18. CHREIN M. B., RUBIN I. L. Agranulocytosis secondary to hydrochlorothiazide therapy. Report of a case. JAMA. 1962 Jul 7;181:54–55. doi: 10.1001/jama.1962.03050270056014c. [DOI] [PubMed] [Google Scholar]
  19. CHRISTEAS N., KOTTAKIS G., GEORGIADES N. Absorption of ascitic fluid by intestinal entectropy. An experimental study. J Int Coll Surg. 1961 Apr;35:446–450. [PubMed] [Google Scholar]
  20. CLOWDUS B. F., 2nd, SUMMERSKILL W. H., CASEY T. H., HIGGINS J. A., ORVIS A. L. Isotope studies of the development of water and electrolyte disorders and azotemia during the treatment of ascites. Gastroenterology. 1961 Oct;41:360–370. [PubMed] [Google Scholar]
  21. CLOWDUS B. F., HIGGINS J. A., ROSEVEAR J. W., SUMMERSKILL W. H. Treatment of "refractory" ascites with a new aldosterone antagonist in patients with cirrhosis. Proc Staff Meet Mayo Clin. 1960 Mar 2;35:97–103. [PubMed] [Google Scholar]
  22. CRANE C. The choice of shunt procedure for cirrhotic patients with variceal bleeding, ascites, and hypersplenism. Surg Gynecol Obstet. 1962 Jul;115:12–28. [PubMed] [Google Scholar]
  23. DAWSON A. M., SHERLOCK S., SUMMERSKILL W. H. The treatment and prognosis of hepatic coma. Lancet. 1956 Oct 6;271(6945):689–694. doi: 10.1016/s0140-6736(56)92383-2. [DOI] [PubMed] [Google Scholar]
  24. DE WARDENER H. E., MILLS I. H., CLAPHAM W. F., HAYTER C. J. Studies on the efferent mechanism of the sodium diuresis which follows the administration of intravenous saline in the dog. Clin Sci. 1961 Oct;21:249–258. [PubMed] [Google Scholar]
  25. DINGMAN J. F., YOFFEE H. F. Effect of calcium gluconate and adrenal steroids on sodium and water excretion in patients with cirrhosis and ascites. N Engl J Med. 1960 Mar 24;262:585–590. doi: 10.1056/NEJM196003242621201. [DOI] [PubMed] [Google Scholar]
  26. DONNELLY R. J., TURNER P., SOWRY G. S. Clinical trial of new oral diuretic-SKF 8542. Lancet. 1962 Feb 3;1(7223):245–247. doi: 10.1016/s0140-6736(62)91192-3. [DOI] [PubMed] [Google Scholar]
  27. DUMONT A. E., MULHOLLAND J. H. Flow rate and composition of thoracic-duct lymph in patients with cirrhosis. N Engl J Med. 1960 Sep 8;263:471–474. doi: 10.1056/NEJM196009082631001. [DOI] [PubMed] [Google Scholar]
  28. DYKES P. W. A study of the effects of albumin infusions in patients with cirrhosis of the liver. Q J Med. 1961 Jul;30:297–327. [PubMed] [Google Scholar]
  29. EDMONDS C. J. An aldosterone antagonist and diuretics in the treatment of chronic oedema and ascites. Lancet. 1960 Mar 5;1(7123):509–515. doi: 10.1016/s0140-6736(60)90448-7. [DOI] [PubMed] [Google Scholar]
  30. EDMONDS C. J., WILSON G. M. The action of hydroflumethiazide in relation to adrenal steroids and potassium loss. Lancet. 1960 Mar 5;1(7123):505–509. doi: 10.1016/s0140-6736(60)90447-5. [DOI] [PubMed] [Google Scholar]
  31. EISENMENGER W. J., NICKEL W. F. Relationship of portal hypertension to ascites in Laennec's cirrhosis. Am J Med. 1956 Jun;20(6):879–889. doi: 10.1016/0002-9343(56)90208-x. [DOI] [PubMed] [Google Scholar]
  32. EISENMENGER W. J. Rôle of sodium in the formation and control of ascites in patients with cirrhosis. Ann Intern Med. 1952 Aug;37(2):261–272. doi: 10.7326/0003-4819-37-2-261. [DOI] [PubMed] [Google Scholar]
  33. EL-TORAEI I. Surgical treatment of cirrhotic ascites with a new operation (pleuroperitoneostomy). J Int Coll Surg. 1961 Apr;35:436–445. [PubMed] [Google Scholar]
  34. Faloon W. W., Eckhardt R. D., Murphy T. L., Cooper A. M., Davidson C. S. AN EVALUATION OF HUMAN SERUM ALBUMIN IN THE TREATMENT OF CIRRHOSIS OF THE LIVER. J Clin Invest. 1949 Jul;28(4):583–594. doi: 10.1172/JCI102108. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. GIDEKEL L. I., SHERLOCK P., PETERSON A. S., VANAMEE P. Management of refractory fluid retention with a combination of L-arginine monohydrochloride and mercurials. N Engl J Med. 1960 Aug 4;263:221–226. doi: 10.1056/NEJM196008042630502. [DOI] [PubMed] [Google Scholar]
  36. GIGES B., KUNKEL H. G. Osmotic pressure measurements of serum and ascitic fluid in patients with cirrhosis of the liver. J Clin Invest. 1954 Feb;33(2):257–263. doi: 10.1172/JCI102894. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. GLIEDMAN M. L., SELLERS R. D., BURKLE J. S., ENQUIST I. F. Cirrhosis with ascites: hemodynamic observations. Ann Surg. 1962 Jan;155:147–152. doi: 10.1097/00000658-196201000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. GORNEL D. L., LANCESTREMERE R. G., PAPPER S., LOWENSTEIN L. M. Acute changes in renal excretion of water and solute in patients with Laennec's cirrhosis, induced by the administration of the pressor amine, metaraminol. J Clin Invest. 1962 Mar;41:594–603. doi: 10.1172/JCI104514. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. HECKER R., SHERLOCK S. Electrolyte and circulatory changes in terminal liver failure. Lancet. 1956 Dec 1;271(6953):1121–1125. doi: 10.1016/s0140-6736(56)90149-0. [DOI] [PubMed] [Google Scholar]
  40. HERKEN H., SENFT G. [2,4,7-Triamino-6-phenylpteridine as an "aldosterone antagonist"]. Klin Wochenschr. 1961 Dec 1;39:1205–1206. doi: 10.1007/BF01506143. [DOI] [PubMed] [Google Scholar]
  41. HOLUB D. A., JAILER J. W. Sodium and water diuresis in cirrhotic patients with intractable ascites following chemical inhibition of aldosterone synthesis. Ann Intern Med. 1960 Sep;53:425–444. doi: 10.7326/0003-4819-53-3-425. [DOI] [PubMed] [Google Scholar]
  42. HYATT R. E., SMITH J. R. The mechanism of ascites, a physiologic appraisal. Am J Med. 1954 Mar;16(3):434–438. doi: 10.1016/0002-9343(54)90359-9. [DOI] [PubMed] [Google Scholar]
  43. KERR D. N., READ A. E., SHERLOCK S. Dihydrochlorothiazide in control of ascites. Lancet. 1959 Jun 13;1(7085):1221–1223. doi: 10.1016/s0140-6736(59)90897-9. [DOI] [PubMed] [Google Scholar]
  44. LASSER R. P., SCHOENFELD M. R., FRIEDBERG C. K. L-lysine monohydrochloride. A clinical study of its action as a chloruretic acidifying adjuvant to mercurial diuretics. N Engl J Med. 1960 Oct 13;263:728–733. doi: 10.1056/NEJM196010132631504. [DOI] [PubMed] [Google Scholar]
  45. LEGER L., GUYET P. La stase lymphatique dans les cirrhoses du foie. Presse Med. 1957 Nov 27;65(86):1930–1932. [PubMed] [Google Scholar]
  46. LIEBOWITZ H. R. Hazards of abdominal paracentesis in the cirrhotic patient. I. N Y State J Med. 1962 Jun 1;62:1822–1826. [PubMed] [Google Scholar]
  47. LOCKWOOD C. H. Spironolactone (Aldactone) therapy for ascites due to cirrhosis of the liver. Can Med Assoc J. 1961 Sep 9;85:631–637. [PMC free article] [PubMed] [Google Scholar]
  48. LOSOWSKY M. S., ATKINSON M. Intravenous albumin in the treatment of diuretic-resistant ascites in portal cirrhosis. Lancet. 1961 Aug 19;2(7199):386–389. doi: 10.1016/s0140-6736(61)92479-5. [DOI] [PubMed] [Google Scholar]
  49. MILLS I. H., DE WARDENER H. E., HAYTER C. J., CLAPHAM W. F. Studies on the afferent mechanism of the sodium chloride diuresis which follows intravenous saline in the dog. Clin Sci. 1961 Oct;21:259–264. [PubMed] [Google Scholar]
  50. MONROE K. E., GRANT L. H., SASAHARA A. A., LITTMANN D. Effect of chlorothiazide therapy on serum uric acid and uric acid excretion. N Engl J Med. 1959 Aug 6;261(6):290–292. doi: 10.1056/NEJM195908062610608. [DOI] [PubMed] [Google Scholar]
  51. MORRISON R. S., CHALMERS T. C. Combined diuretic and steroid therapy in cirrhosis with ascites. Ann N Y Acad Sci. 1960 Oct 11;88:907–914. doi: 10.1111/j.1749-6632.1960.tb20080.x. [DOI] [PubMed] [Google Scholar]
  52. MURPHY J., CASEY W., LASAGNA L. The effect of dosage regimen on the diuretic efficacy of chlorothiazide in human subjects. J Pharmacol Exp Ther. 1961 Dec;134:286–290. [PubMed] [Google Scholar]
  53. McDERMOTT W. V., Jr The treatment of cirrhotic ascites by combined hepatic and portal decompression. N Engl J Med. 1958 Nov 6;259(19):899–901. doi: 10.1056/NEJM195811062591901. [DOI] [PubMed] [Google Scholar]
  54. NAGANT DE DEUXCHAISNES C., COLLET R. A., BUSSET R., MACH R. S. Exchangeable potassium in wasting, amyotrophy, heart-disease, and cirrhosis of the liver. Lancet. 1961 Apr 1;1(7179):681–687. doi: 10.1016/s0140-6736(61)91719-6. [DOI] [PubMed] [Google Scholar]
  55. NELSON W. P., 3rd, ROSENBAUM J. D., STRAUSS M. B. Hyponatremia in hepatic cirrhosis following paracentesis. J Clin Invest. 1951 Jul;30(7):738–744. doi: 10.1172/JCI102487. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. OGDEN D. A., SCHERR L., SPRITZ N., RUBIN A. L. A comparison of the properties of chlorothiazide, spironolactone and a combination of both as diuretic agents. N Engl J Med. 1961 Aug 24;265:358–362. doi: 10.1056/NEJM196108242650802. [DOI] [PubMed] [Google Scholar]
  57. OWEN E. E., FLANAGAN J. F., TYOR M. P. Kidney as a source of blood ammonia: effect of chlorothiazide. Proc Soc Exp Biol Med. 1959 Oct-Dec;102:696–697. doi: 10.3181/00379727-102-25366. [DOI] [PubMed] [Google Scholar]
  58. PAPPER S., BELSKY J. L., BLEIFER K. H. Renal failure in Laennec's cirrhosis of the liver. I. Description of clinical and laboratory features. Ann Intern Med. 1959 Oct;51:759–773. doi: 10.7326/0003-4819-51-4-759. [DOI] [PubMed] [Google Scholar]
  59. READ A. E., HASLAM R. M., LAIDLAW J., SHERLOCK S. Chlorothiazide in control of ascites in hepatic cirrhosis. Br Med J. 1958 Apr 26;1(5077):963–966. doi: 10.1136/bmj.1.5077.963. [DOI] [PMC free article] [PubMed] [Google Scholar]
  60. READ A. E., LAIDLAW J., SHERLOCK S. Neuropsychiatric complications of portacaval anastomosis. Lancet. 1961 May 6;1(7184):961–963. doi: 10.1016/s0140-6736(61)91880-3. [DOI] [PubMed] [Google Scholar]
  61. SCHEDL H. P., BARTTER F. C. An explanation for and experimental correction of the abnormal water diuresis in cirrhosis. J Clin Invest. 1960 Feb;39:248–261. doi: 10.1172/JCI104035. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. SHALDON S., DOLLE W., GUEVARA L., IBER F. L., SHERLOCK S. Effect of pitressin on the splanchnic circulation in man. Circulation. 1961 Oct;24:797–807. doi: 10.1161/01.cir.24.4.797. [DOI] [PubMed] [Google Scholar]
  63. SHALDON S., HIGGS B., CHIANDUSSI L., WALKER G., GARSENSTEIN M., RYDER J. Measurement of renal blood flow in man with the use of indocyanine green infused into the renal artery. J Lab Clin Med. 1962 Dec;60:954–966. [PubMed] [Google Scholar]
  64. SHALDON S., McLAREN J. R. An 11beta-hydroxylase inhibitor in the treatment of resistant ascites. Lancet. 1960 Dec 17;2(7164):1330–1332. doi: 10.1016/s0140-6736(60)92522-8. [DOI] [PubMed] [Google Scholar]
  65. SHALDON S., McLAREN J. R., SHERLOCK S. Resistant ascites treated by combined diuretic therapy (spironolactone, mannitol, and chlorothiazide). Lancet. 1960 Mar 19;1(7125):609–613. doi: 10.1016/s0140-6736(60)90500-6. [DOI] [PubMed] [Google Scholar]
  66. SHALDON S., RYDER J. A., GARSENSTEIN M. A comparison of the use of Aldactone and Aldactone A in the treatment of hepatic ascites. Gut. 1963 Mar;4:16–19. doi: 10.1136/gut.4.1.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  67. SHALDON S., RYDER J. A. Use of a pteridine diuretic (tri-amterene) in treatment of hepatic ascites. Br Med J. 1962 Sep 22;2(5307):764–767. doi: 10.1136/bmj.2.5307.764. [DOI] [PMC free article] [PubMed] [Google Scholar]
  68. SHANKLIN D. R. Pancreatic atrophy apparently secondary to hydrochlorothiazide. N Engl J Med. 1962 May 24;266:1097–1099. doi: 10.1056/NEJM196205242662108. [DOI] [PubMed] [Google Scholar]
  69. SHOENBERGER J. A., KROLL G., SAKAMOTO A., KARK R. M. Investigation of the permeability factor in ascites and edema using albumin tagged with I 131. Gastroenterology. 1952 Dec;22(4):607–622. [PubMed] [Google Scholar]
  70. SMITH A. N., PRESHAW R. M., BISSET W. H. The drainage of resistant ascites, by a modification of the Spitz-Holter valve technique. J R Coll Surg Edinb. 1962 Jul;7:289–294. [PubMed] [Google Scholar]
  71. SMITH A. N. Peritoneocaval shunt with a Holter valve in the treatment of ascites. Lancet. 1962 Mar 31;1(7231):671–672. doi: 10.1016/s0140-6736(62)92884-2. [DOI] [PubMed] [Google Scholar]
  72. STORMONT J. M., CRABBE J., FAST B., WOLFE S. J., DAVIDSON C. S. The effect of prednisone and amphenone on fluid and electrolyte balance and on aldosterone excretion of patients with cirrhosis and ascites. J Lab Clin Med. 1959 Mar;53(3):396–416. [PubMed] [Google Scholar]
  73. SUMMERSKILL W. H., CLOWDUS B. F., 2nd, ROSEVEAR J. W. Long-term medical management and complications of 'resistant' ascites. Gut. 1961 Dec;2:285–296. doi: 10.1136/gut.2.4.285. [DOI] [PMC free article] [PubMed] [Google Scholar]
  74. Starling E. H. On the Absorption of Fluids from the Connective Tissue Spaces. J Physiol. 1896 May 5;19(4):312–326. doi: 10.1113/jphysiol.1896.sp000596. [DOI] [PMC free article] [PubMed] [Google Scholar]
  75. TAYLOR F. F., FALOON W. W. The role of potassium in the natriuretic response to a steroidal lactone (SC-9420). J Clin Endocrinol Metab. 1959 Dec;19:1683–1687. doi: 10.1210/jcem-19-12-1683. [DOI] [PubMed] [Google Scholar]
  76. VOLWILER W., GRINDLAY J. H., BOLLMAN J. L. The relation of portal vein pressure to the formation of ascites; an experimental study. Gastroenterology. 1950 Jan;14(1):40-55, illust. [PubMed] [Google Scholar]
  77. WELCH C. S., WELCH H. F., CARTER J. H. The treatment of ascites by side to side portacaval shunt. Ann Surg. 1959 Sep;150:428–444. doi: 10.1097/00000658-195909000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  78. WILKINSON P., SHERLOCK S. The effect of repeated albumin infusions in patients with cirrhosis. Lancet. 1962 Dec 1;2(7266):1125–1129. doi: 10.1016/s0140-6736(62)90895-4. [DOI] [PubMed] [Google Scholar]

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