A new approach to the management of malignant ascites; a permanently implanted abdominal drain

A new approach to the problem of intractable malignant ascites in preterminal abdominal carcinoma is presented. Seventeen patients treated with a new implantable silastic drain are described. Symptomatic relief was excellent in all patients for as long as the drain was patent. Complications included abdominal wall cellulitis in two instances and one case of peritonitis, but did not preclude continued drain function in 15 of the 17 cases. In eight of the 17 cases organisms were cultured from the ascitic fluid while the catheter was in situ. Drainage of ascitic fluid in this way appears to be a practical management for intractable malignant ascites.