To obtain a reasonable estimate in vivo of the liver extracellular space (ECS) in intact, non-exsanguinated dogs, the distribution volumes of a variety of radioactive tracers were obtained as a function of time. 36Cl, 14C- and 3H-inulin, 125I-albumin, 51Cr-red cells, and endogenous 35Cl distribution volumes were obtained in liver from 5 min to 4 h. The 36Cl space was stable and reproducible at 29.0%, a value similar to the endogenous 35Cl (28.2%) and 5 min 14C-inulin (29.9%) spaces. The 36Cl space may be used as the upper limit of liver ECS, whereas the inulin space exceeds this value after 5 min and progressively increases. Electrolyte concentrations in liver cell water are calculated using the 36Cl space of 29% as the liver ECS. The advantages of using 36Cl over other methods to determine liver ECS in intact animals are discussed.
A 14-year-old girl was brought to the A & E department minutes after collapsing while out walking minutes earlier. She had developed sudden, severe, cramping pain in her lower abdomen and both legs, and had been incontinent of urine. Earlier that day she had an episode of diarrhoea. The girl was previously in excellent health.
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