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Salt and Water Balance Before and After Peritoneojugular and Portacaval Shunts

Salt and Water Balance Before and After Peritoneojugular and Portacaval Shunts Abstract • Renal salt and water handling were studied in a patient who had refractory ascites that were due to alcoholic liver disease. The patient underwent a peritoneojugular shunt that was followed eight weeks later by a portacaval shunt. Ingestion of a 10-mEq sodium diet and albumin infusion had no effect on sodium balance but increased free water clearance before and after the operative procedures. After peritoneojugular shunt, free water clearance and sodium excretion increased. After portacaval shunt, free water clearance decreased and sodium retention occurred. (Arch Surg 113:646-649, 1978) References 1. Sherlock S: Diseases of the Liver and Biliary System , ed 5. Oxford, England, Blackwell Scientific Publications, 1975, p 130-138. 2. Orloff MJ: Effect of side-to-side portacaval shunt in intractible ascites, sodium excretion, and aldosterone metabolism in man . Am J Surg 112:287-298, 1966.Crossref 3. Shinaberger JH: Galambos JT: Management of "refractory" ascites based on correction of specific physiologic lesions . Am J Gastroenterol 41:499-510, 1964. 4. Summerskill WHJ, Clowdus BF II, Rosevear JW: Long-term medical management and complications of "resistant" ascites . Gut 2:285-296, 1961.Crossref 5. Resnick RH, Iber FL, Ishihara AM, et al: A controlled study of therapeutic portacaval shunt . Gastroenterology 67:843-857, 1974. 6. Malt RA: Portasystemic venous shunts . N Engl J Med 295:24-29, 80-86, 1976.Crossref 7. LeVeen HH, Christoudias G, Ip M, et al: Peritoneo-venous shunting for ascites . Ann Surg 180:580-586, 1974.Crossref 8. LeVeen HH, Wapnick S, Grosberg S, et al: Further experience with peritoneo-venous shunt for ascites . Ann Surg 184:574-581, 1976.Crossref 9. Wapnick S, Grosberg S, Kinney M, et al: LeVeen continuous peritoneal-jugular shunt . JAMA 237:131-133, 1977.Crossref 10. Chaimovitz C, Szylman P, Alroy G, et al: Mechanism of increased renal tubular sodium reabsorption in cirrhosis . Am J Med 52:198-202, 1972.Crossref 11. Farnswork EB, Kraukusin JS: Electrolyte partition in patients with edema of various origins: Qualitative and quantitative definition of cations and anions in hepatic cirrhosis . J Lab Clin Med 33:1545, 1948. 12. Ralli EP, Leslie SH, Stueck GH Jr, et al: Studies of the serum and urine constituents in patients with cirrhosis of the liver during water tolerance tests . Am J Med 11:157, 1951.Crossref 13. Papper S: The role of the kidney in Laënnec's cirrhosis of the liver . Medicine (Baltimore) 37:299, 1958.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Salt and Water Balance Before and After Peritoneojugular and Portacaval Shunts

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Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1978.01370170108023
Publisher site
See Article on Publisher Site

Abstract

Abstract • Renal salt and water handling were studied in a patient who had refractory ascites that were due to alcoholic liver disease. The patient underwent a peritoneojugular shunt that was followed eight weeks later by a portacaval shunt. Ingestion of a 10-mEq sodium diet and albumin infusion had no effect on sodium balance but increased free water clearance before and after the operative procedures. After peritoneojugular shunt, free water clearance and sodium excretion increased. After portacaval shunt, free water clearance decreased and sodium retention occurred. (Arch Surg 113:646-649, 1978) References 1. Sherlock S: Diseases of the Liver and Biliary System , ed 5. Oxford, England, Blackwell Scientific Publications, 1975, p 130-138. 2. Orloff MJ: Effect of side-to-side portacaval shunt in intractible ascites, sodium excretion, and aldosterone metabolism in man . Am J Surg 112:287-298, 1966.Crossref 3. Shinaberger JH: Galambos JT: Management of "refractory" ascites based on correction of specific physiologic lesions . Am J Gastroenterol 41:499-510, 1964. 4. Summerskill WHJ, Clowdus BF II, Rosevear JW: Long-term medical management and complications of "resistant" ascites . Gut 2:285-296, 1961.Crossref 5. Resnick RH, Iber FL, Ishihara AM, et al: A controlled study of therapeutic portacaval shunt . Gastroenterology 67:843-857, 1974. 6. Malt RA: Portasystemic venous shunts . N Engl J Med 295:24-29, 80-86, 1976.Crossref 7. LeVeen HH, Christoudias G, Ip M, et al: Peritoneo-venous shunting for ascites . Ann Surg 180:580-586, 1974.Crossref 8. LeVeen HH, Wapnick S, Grosberg S, et al: Further experience with peritoneo-venous shunt for ascites . Ann Surg 184:574-581, 1976.Crossref 9. Wapnick S, Grosberg S, Kinney M, et al: LeVeen continuous peritoneal-jugular shunt . JAMA 237:131-133, 1977.Crossref 10. Chaimovitz C, Szylman P, Alroy G, et al: Mechanism of increased renal tubular sodium reabsorption in cirrhosis . Am J Med 52:198-202, 1972.Crossref 11. Farnswork EB, Kraukusin JS: Electrolyte partition in patients with edema of various origins: Qualitative and quantitative definition of cations and anions in hepatic cirrhosis . J Lab Clin Med 33:1545, 1948. 12. Ralli EP, Leslie SH, Stueck GH Jr, et al: Studies of the serum and urine constituents in patients with cirrhosis of the liver during water tolerance tests . Am J Med 11:157, 1951.Crossref 13. Papper S: The role of the kidney in Laënnec's cirrhosis of the liver . Medicine (Baltimore) 37:299, 1958.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 1978

References