OBSERVATIONS ON PORTAL CIRRHOSIS WITH ASCITES
Authors: W E RICKETTS
Journal: Annals of Internal Medicine (1951)

Article1 January 1951OBSERVATIONS ON PORTAL CIRRHOSIS WITH ASCITESWILLIAM E. RICKETTS, M.D., Ph.D.WILLIAM E. RICKETTS, M.D., Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-34-1-37 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe pathogenesis, as well as the treatment, of edema and ascites in portal cirrhosis has been a subject of utmost interest and continuous investigation. Attention has been directed to the rôle of proteins and the colloid osmotic pressure of the plasma,1, 2, 3, 4, 5, 6, 7, 8, 9to disturbances in electrolyte excretion10, 11, 12and to urine output.6Previous studies have shown that the plasma albumin was consistently within the normal range in patients with latent, asymptomatic cirrhosis,13, 14whereas it was consistently reduced in patients with portal cirrhosis accompanied by severe jaundice and ascites. Clinical improvement following...Bibliography1. Govaerts P: Osmotic pressure of serum proteins, Compt. rend. Soc. de biol. 90: 969, 1924. Google Scholar2. Govaerts P: Influence of protein-globulin ratio on osmotic pressure of serum proteins, Compt. rend. Soc. de biol. 93: 441, 1925. Google Scholar3. von Farcas G: Über die Wirkung des Albumin-Globulien-Quotienten auf den osmotischen Druck des Serums, Ztschr. f. d. ges. exper. Med. 50: 410, 1926. CrossrefGoogle Scholar4. PetersEisenman JPAJ: The serum proteins in diseases not affecting primarily the cardiovascular system or kidneys, Am. J. M. Sc. 186: 808, 1933. CrossrefGoogle Scholar5. PostPatek JAJ: Serum proteins in cirrhosis of the liver. I. Relation to prognosis and to formation of ascites, Arch. Int. Med. 69: 67, 1942. CrossrefGoogle Scholar6. RalliRobsonClarkeHoagland EPJSDCL: Factors influencing ascites in patients with cirrhosis of the liver, J. Clin. Investigation 24: 316, 1945. CrossrefMedlineGoogle Scholar7. WiesPeters CHJP: Osmotic pressure of proteins in whole serum, J. Clin. Investigation 16: 93, 1937. CrossrefMedlineGoogle Scholar8. BjorneboeBranRoaschov MCF: Colloid osmotic pressure in chronic hepatitis: role in pathogenesis of ascites, Nord. med. 35: 1465, 1947. Google Scholar9. ButtSnellKeys HAMA: Plasma proteins in hepatic disease: a study of the colloid osmotic pressure of blood serum and of ascitic fluid in various diseases of the liver, Arch. Int. Med. 63: 143, 1939. CrossrefGoogle Scholar10. LayneSchemm JAFR: The use of a high fluid intake and a low sodium acid-ash diet in the management of portal cirrhosis with ascites, Gastroenterology 9: 705, 1947. MedlineGoogle Scholar11. Farnsworth EB(a) : Electrolyte partition in patients with edema of various origins, Am. J. Med. 4: 338, 1948; (b) Farnsworth et al., J. Lab. and Clin. Med. 33: 1545, 1948; (c) Farnsworth et al., J. Lab. and Clin. Med. 33: 1534, 1948. CrossrefMedlineGoogle Scholar12. RickettsEichelbergerKirsner WELJB: Unpublished data. Google Scholar13. RickettsKirsnerPalmer WEJBWL: The diagnostic value of liver biopsy, tests of hepatic function and electrophoretic fractionation of sera in asymptomatic portal cirrhosis, J. Lab. and Clin. Med. 35: 403, 1950. Google Scholar14. RickettsKirsnerPalmer WEJBWL: Clinical observations on hepatic failure in portal cirrhosis, Gastroenterology 15: 245 (1950). CrossrefMedlineGoogle Scholar15. RickettsKirsnerPalmerKippen WEJBWLDD: Tests of hepatic function in portal cirrhosis, Gastroenterology 15: 40 (1950). CrossrefMedlineGoogle Scholar16. CampbellHanna WRMI: Sulphites as protein precipitants, J. Biol. Chem. 119: 9, 1937. CrossrefGoogle Scholar17. SchadeClausen HF: Die onkotische Druck des Blut Plasmas und die Entstehung der renalbedingten Oedeme, Ztschr. f. klin. Med. 100: 363, 1924. Google Scholar18. GilbertChiray AM: Diminution des substances albumineuses du serum sanguin chez les cirrhotiques ascitiques, Compt. rend. Soc. de biol. 63: 497, 1907. Google Scholar19. Grenet H: Diminution des albumines du serum sanguin chez les hepatiques, Compt. rend. Soc. de biol. 63: 552, 1907. Google Scholar20. Filinski W: L'augmentation du taux de la globuline dans le serum du sang comme resultat de l'insuffisance hepatique, Presse méd. 30: 236, 1922. Google Scholar21. AtchleyLoebBenedict DWRFEM: Physical and chemical studies of human serum blood; study of miscellaneous disease conditions, Arch. Int. Med. 31: 616, 1923. CrossrefGoogle Scholar22. AbramiWallick PR: Modifications du serum sanguin du foie avec ascites: In vertion du rapport serines-globulines, Compt. rend. Soc. de biol. 101: 291, 1929. Google Scholar23. Salvensen HA: Variations of plasma proteins in non-renal conditions, Acta med. Scandinav. 72: 113, 1929. CrossrefGoogle Scholar24. Hand HM: Concentration of serum proteins in different types of edema; illustrative cases, Arch. Int. Med. 54: 215, 1934. CrossrefGoogle Scholar25. MeyersKeefer WKCS: Relation of plasma proteins to ascites and edema of cirrhosis of the liver, Arch. Int. Med. 55: 349, 1935. CrossrefGoogle Scholar26. TumenBockus HHL: Clinical significance of serum proteins in hepatic diseases as compared with other liver function tests, Am. J. M. Sc. 193: 788, 1937. CrossrefGoogle Scholar27. FoleyKeetonKendrickDarling EFAWABD: Alterations of serum proteins as index of hepatic failure, Arch. Int. Med. 60: 64, 1937. CrossrefGoogle Scholar28. Kendall FE: Studies on serum protein. I. Identification of a single serum globulin by immunological means; distribution of the sera of normal individuals and patients with cirrhosis of the liver and with chronic glomerulonephritis, J. Clin. Investigation 16: 921, 1937. CrossrefMedlineGoogle Scholar29. DauphineeCampbell JAWR: Serum proteins in hepatic disease, M. Clin. North America 32: 236, 1930. Google Scholar30. WienerWiener HJRE: Plasma proteins, Arch. Int. Med. 46: 236, 1930. CrossrefGoogle Scholar31. RimmermanSchwartzPopperSteigman ABSOHF: Dietary factors in the treatment of dietary cirrhosis with jaundice, Am. J. Digest. Dis. 11: 401, 1944. CrossrefGoogle Scholar32. Gutman AB: The plasma proteins in disease, Advances in Protein Chemistry 4: 221, 1948. Google Scholar33. Luetscher JA: Electrophoretic analysis of the proteins of plasma and serous effusions, J. Clin. Investigation 19: 313, 1940. CrossrefMedlineGoogle Scholar34. GrayBarron SJES: The electrophoretic analysis of the serum proteins in diseases of the liver, J. Clin. Investigation 22: 191, 1943. CrossrefMedlineGoogle Scholar35. RickettsSterlingKirsnerPalmer WEKJBWL: Electrophoretic studies of the serum proteins in portal cirrhosis, Gastroenterology 13: 205, 1940. Google Scholar36. SterlingRickettsKirsnerPalmer KWEJBWL: The serum proteins in portal cirrhosis under medical management. Electrophoretic studies, J. Clin. Investigation 28: 1236, 1949. CrossrefGoogle Scholar37. HoaglandDietrick CLJE: Conference on therapy; the modern treatment of cirrhosis of the liver and hepatic insufficiency, New York State J. Med. 43: 1041, 1943. Google Scholar38. GoldschmidtVarsRandin SHMIS: The influence of foodstuffs upon the susceptibility of the liver to injury by chloroform and the probable mechanism of their action, J. Clin. Investigation 18: 277, 1939. CrossrefMedlineGoogle Scholar39. MillerRossWhipple LLJFGH: Methionine and cystine, specific protein factors preventing chloroform liver injury in protein-depleted dogs, Am. J. M. Sc. 200: 739, 1940. CrossrefGoogle Scholar40. McHenryPatterson GWJM: Hypotrophic factors, Physiol. Rev. 24: 128-167, 1944. CrossrefGoogle Scholar41. Hoagland CL: The therapy of liver diseases, Bull. New York Acad. Med. 21: 537, 1945. MedlineGoogle Scholar42. PatekPost AJ: Treatment of cirrhosis of the liver by a nutritious diet and supplement rich in vitamin B complex, J. Clin. Investigation 20: 481, 1941. CrossrefMedlineGoogle Scholar43. KunkelLabbyAhrensShankHoagland HGDHEHRECL: Use of concentrated human serum albumin in treatment of cirrhosis of the liver, J. Clin. Investigation 27: 305, 1948. CrossrefGoogle Scholar44. ThornArmstrongDavenport GWSHVD: Chemical, clinical, and immunological studies on products of human plasma fractionation; use of salt poor concentrated human serum albumin solution in the treatment of hepatic cirrhosis, J. Clin. Investigation 25: 304, 1946. CrossrefGoogle Scholar45. Kunkel HG: Treatment of cirrhosis with concentrated human albumin solution. Conference on liver injury sponsored by the Josiah Macy, Jr. Foundation, Tr. Fifth Meet. Sept. 26-27, 1946. Google Scholar46. MankinLowell HA: Osmotic factors influencing formation of ascites in patients with cirrhosis of the liver, J. Clin. Investigation 27: 145, 1948. CrossrefMedlineGoogle Scholar47. PatekMankinColcherLowellEarle AJHHADP: Effects of intravenous injection of concentrated human serum albumin upon blood plasma, ascites and renal functions in three patients with cirrhosis of the liver, J. Clin. Investigation 27: 135, 1948. CrossrefGoogle Scholar48. Armstrong SH: Mechanisms of action of serum albumin therapy in internal medicine, Am. J. Med. 4: 390, 1948. CrossrefMedlineGoogle Scholar49. FaloonEckhardtMurphyCooperDavidson WWRDTLAMCS: An evaluation of human serum albumin in the treatment of cirrhosis of the liver, J. Clin. Investigation 28: 583, 1949. CrossrefGoogle Scholar50. PatekPostTatnoffMankinHillman AJJODHHRW: Dietary treatment of cirrhosis of the liver, J. A. M. A. 138: 543, 1948. CrossrefMedlineGoogle Scholar51. RowntreeChapmanSnell LGHBAB: Cirrhosis of the liver, Post-Grad. M. A. North America Assemb. Interstate 6: 560, 1930. Google Scholar52. Lusk G: Physiological effect of undernutrition, Physiol. Rev. 1: 523, 1921. CrossrefGoogle Scholar53. Kohman EA: Experimental production of edema related to plasma deficiency, Am. J. Physiol. 51: 378, 1920. CrossrefGoogle Scholar54. BruckmanD'EsopoPeters FSLMJP: Malnutrition and the serum proteins, J. Clin. Investigation 8: 577, 1929-30. CrossrefGoogle Scholar55. FrischMendelPeters RAJBJP: Production of edema and serum deficiency in white rats by low protein diets, J. Biol. Chem. 84: 167, 1929. CrossrefGoogle Scholar56. YoumansBellDunleyFrank JBADH: Endemic nutritional edema. I. Clinical findings and dietary studies, Arch. Int. Med. 50: 843, 1932; II. Serum proteins and nitrogen balance, Arch. Int. Med. 51: 45, 1933. CrossrefGoogle Scholar57. WeechSnellingGoettsch AACEE: Relation between plasma protein content, plasma specific gravity and edema in dogs maintained on protein inadequate diet and in dogs rendered edematous by plasmapheresis, J. Clin. Investigation 12: 193, 1933. CrossrefMedlineGoogle Scholar58. DarrowHooperCary DGEBMC: Plasmapheresis edema. Relation of reduction of serum proteins to edema and pathological anatomy accompanying plasmapheresis, J. Clin. Investigation 11: 683, 1932. CrossrefMedlineGoogle Scholar59. Lepore MJ: Experimental edema produced by plasma protein depletion, Arch. Int. Med. 50: 488, 1932. CrossrefGoogle Scholar60. Leiter L: Experimental nephritic edema, Arch. Int. Med. 48: 1, 1931. CrossrefGoogle Scholar61. Moorevan Slyke NSDD: Relation between plasma specific gravity, plasma protein content and edema in nephritis, J. Clin. Investigation 8: 337, 1930. CrossrefMedlineGoogle Scholar62. RickettsLushbaughKirsnerPalmer WECCJBWL: Pathological observations on portal cirrhosis, Gastroenterology 14: 491 (1950). CrossrefMedlineGoogle Scholar63. Henrickson EC: Cirrhosis of the liver with special reference to surgical aspects, Arch. Surg. 32: 413, 1936. CrossrefGoogle Scholar64. Blakemore AH: Portocaval anastomosis for the relief of portal hypertension, Gastroenterology, 11: 488, 1948. MedlineGoogle Scholar65. VolwilerGrindlayBollman WJHJH: The relation of portal vein pressure to the formation of ascites—an experimental study, Gastroenterology 14: 40, 1950. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, Illinois*Received for publication May 17, 1950.From the Frank Billings Clinic, the Department of Medicine, University of Chicago, Chicago, Illinois. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHigh prevalence of normal serum albumin in NASH patients with ascites: A retrospective analysisThe relationship between portal pressure and plasma albumin in the development of cirrhotic ascitesA Rational Approach to the Treatment of Ascites in Laennec's CirrhosisLocal Factors in Ascites Formation in Chronic Liver DiseaseTHE EFFECT OF REPEATED ALBUMIN INFUSIONS IN PATIENTS WITH CIRRHOSISAscitesREFERENCESWHAT IS IMPORTANT IN THE TREATMENT OF LIVER DISEASE*I. FRANK TULLIS, M.D., F.A.C.P.A Comparative Study of Portal and Bilharzial CirrhosisThe mechanism of ascitesDie Krankheiten der Leber und der GallenwegeAcute and Chronic Hepatitis: Diagnosis, Course and ManagementJaundice in Chronic Hepatitis (Cirrhosis of the Liver) 1 January 1951Volume 34, Issue 1Page: 37-60KeywordsAlbuminsAscitesBlood plasmaCirrhosisEdemaOsmotic pressurePathogenesisPlasma proteinsUrine ePublished: 1 December 2008 Issue Published: 1 January 1951 PDF downloadLoading ...