The site in the peritoneal cavity at which ascitic fluid forms in patients with cirrhosis has not been directly demonstrated. The present tendency, however, is to regard the matter as settled, but it is our belief that the question should still remain open.
The two main suggestions are that the fluid escapes through the capsule of the liver or through the serosal surfaces of the gut and mesentery. The evidence for and against each of these will be summarized.
The former view is based on a comparison of the ascites of cirrhosis with that of experimental ascites produced by constriction of the thoracic portion of the inferior vena cava. Richard Lower (1631-1691, quoter by Bolton1) was the first to produce ascites in this way, and Bolton and Barnard2 were the first to suggest that the fluid exuded from the surface of the liver. This has since been confirmed
Losowsky MS, Davidson CS. The Source of Ascitic Fluid in Cirrhosis of the Liver. Arch Intern Med. 1962;110(3):279-282. doi:10.1001/archinte.1962.03620210003002