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August 1957

Portal Circulation in Constrictive Pericarditis: A Study of the Spleen-Lung Ether Time in Relation to Splenoportography Before and After Pericardiectomy

Author Affiliations

Madrid, Spain

Department of Internal Medicine, University of Madrid (Professor, Dr. Gilsanz).

AMA Arch Intern Med. 1957;100(2):201-208. doi:10.1001/archinte.1957.00260080027007

As is well known, one of the most frequent signs which can be found in the clinical picture of constrictive pericarditis is ascites that has the peculiarity of being quite persistent.

By means of medical treatment alone (mercurial diuretics, salt-free diet, etc.) it is very difficult to achieve a regression of the ascites. Thus it has been necessary to explain the mechanism of production of this ascites as due to some mechanical factor which obstructs the venous return in the inferior vena cava; this assumption is corroborated by the fact that spectacular results are obtained in this respect by means of surgical treatment (pericardiectomy). It is important to point out, however, that there must be something which produces a local obstruction of the portal circulation at an intra- or suprahepatic level and which is capable of producing an isolated ascites without accompanying peripheral edema. Apart from the general venous hypertension

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