One of the commonest complications of cirrhosis of the liver is the formation of ascites. While in some patients the ascites can be easily controlled with sodium restriction and the use of diuretics, in others these measures are ineffective. In this latter instance, rigid restriction of dietary sodium is mandatory if frequent paracenteses are to be avoided. Even with a restricted sodium intake, if the use of diuretics is ineffective in enhancing urinary sodium excretion there is usually a very slow progression in the accumulation of ascitic fluid. These patients, with cirrhosis and ascites resistant to treatment with potent diuretics, present a very difficult therapeutic problem. Such radical measures as a surgical portacaval shunt (1) and bilateral adrenalectomy (2) have been applied in an effort to control the ascites formation in this type of patient.
The organomercurial diuretics are frequently ineffective in promoting a sodium diuresis, and potentiation of their
REDEKER AG, KUZMA OT, REYNOLDS TB. An Effective Treatment of Refractory Ascites in Cirrhosis of the Liver. AMA Arch Intern Med. 1960;105(4):594–600. doi:10.1001/archinte.1960.00270160092011
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