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January 8, 1968

Effect of Thoracic Duct Decompression on Ascites

Author Affiliations

From the departments of surgery (Drs. Fish and Williams) and medicine (Drs. Sarles and Remmers), University of Texas Medical Branch, Galveston. Dr. Fish is an advanced clinical fellow of the American Cancer Society.

JAMA. 1968;203(2):98-102. doi:10.1001/jama.1968.03140020026006

Decompression of the thoracic lymph duct reportedly causes regression of ascites. Four patients were studied under careful conditions of metabolic balance during thoracic duct drainage and reinfusion of lymph. Decompression alone did not change the ascites. If a negative water and sodium balance was produced, such as by dialysis of the lymph, a corresponding reduction in ascites was effected. This effect was similar to the results from paracentesis, diuretics, or ascites autotransfusion. In one patient, ascites autotransfusion resulted in a four-fold increase in the lymph flow rate. It is postulated that the accelerated lymph flow resulted from an expansion of the plasma volume by ascites, which resulted in an increased blood flow to the liver and an increased transudation of lymph at the postsinusoidal block.