The surgical treatment of the ascites of cirrhosis of the liver is based upon the assumption that the ascites is due to an abnormal increase in the blood pressure in the portal radicles, which in turn is produced by the peculiar changes in the liver, causing an obstruction to the passage of the blood of the portal system to that of the general system. The portal system at one time was thought to be a closed circulation, but it has been known now for some time that a number of small anastomoses exist between some of the radicles of the portal system and those of the vena cava which permit a certain amount of the portal blood to reach the general circulation without passing through the liver. Under normal conditions the amount of portal blood thus reaching the vena cava is comparatively small, but in the presence of an obstruction
HARRIS ML. THE SURGICAL TREATMENT OF ASCITES DUE TO CIRRHOSIS OF THE LIVER. JAMA. 1902;XXXVIII(18):1137–1142. doi:10.1001/jama.1902.62480180015001d
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