Ascites: An Operation for its Relief. A Case Report

Ferguson, Charles

doi:10.1016/s0022-5347(17)70432-6

Cited by 8 publications

(1 citation statement)

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“…In 1954, following the synthesis of cortisone and the establishment of feasibility of bilateral adrenalectomy, Marson [154] reported on total adrenalectomy in the treatment of hepatic cirrhosis with ascites. Ferguson in 1943 [155] performed a nephrectomy and anastomosed the renal pelvis to the peritoneal cavity. The omenturn twice migrated to and occluded the communication between the peritoneal cavity and the renal pelvis, requiring 2 subsequent operations for re-positioning of the renal pelvis.…”

Section: Ascitesmentioning

confidence: 99%

Surgical treatment of portal hypertension: A historical perspective

Donovan

1984

World j. surg.

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Portal hypertension has been treated surgically by diversion of blood from the portal system, by interruption of the flow of blood to esophageal varices, or by direct obliteration of the varices. At the beginning of the twentieth century, portal diversion was achieved by omentopexy and, in a few patients, by the creation of a portacaval shunt. The latter operation was abandoned because of high mortality and morbidity rates, including shunt encephalopathy. In the 1940's, interest was renewed in the portacaval shunt. Improved understanding of hepatic physiology and the establishment of precise criteria for selection of cases for surgery resulted in a low operative mortality rate. The operation was highly successful in the control of hemorrhage from esophageal varices but was associated with an undesirable incidence of impairment of hepatic function. Currently, selective decompression of varices by the distal splenorenal shunt is under evaluation as a method of preventing variceal hemorrhage, while preserving hepatic function. Elimination of the threat of hemorrhage from varices by arterial ligation, sclerotherapy, or direct suture has been practiced for almost a century. The result remains one of temporary control with recurrent hemorrhage in the majority of cases.Ascites was formerly considered the dominant manifestation of portal hypertension. Currently, it is usually well controlled by diuretics. Surgery is reserved for the rare case of intractable ascites, often with hepatorenal syndrome. In such cases, a shunt is established between the peritoneal cavity and the systemic venous system, a procedure first performed early in this century.

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Section: Ascitesmentioning

confidence: 99%

Surgical treatment of portal hypertension: A historical perspective

Donovan

1984

World j. surg.

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The History of the Surgical Treatment of Portal Hypertension

Chandler

1993

Arch Surg

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The treatment of resistant malignant ascites by insertion of a peritoneo-atrial Holter valve

Pollock

1975

Journal of British Surgery

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Holter valves have been used in 9 cases to drain ascites, and in 1 case of pleural effusion, into the superior vena cava. All these effusions were due to malignant disease. Three patients died before the results of the operation could be assessed and in 1 case ascites rapidly recurred. Five patients were relieved until death from their primary disease. One patient died 3 1/4 years after insertion of the valve, but ascites had returned--probably as a result of recurrent blockage of the valve by particulate matter.

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Ascites: An Operation for its Relief. A Case Report

Cited by 8 publications

References 0 publications

Surgical treatment of portal hypertension: A historical perspective

Surgical treatment of portal hypertension: A historical perspective

The History of the Surgical Treatment of Portal Hypertension

The treatment of resistant malignant ascites by insertion of a peritoneo-atrial Holter valve

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