[Diuretic resistant ascites in hepatic cirrhosis and renal insufficiency (author's transl)]

In decompensated hepatic cirrhosis the glomerular filtration rate is reduced. Use of diuretics frequently leads to hyponatraemia, hypotension, hypovolaemia and oliguria. The ensuing renal insufficiency is reversible when the peritoneal fluid is redirected into the vascular system. For this purpose a subcutaneously implantable pump developed by Agishi was used in a 37-year-old patient permitting drainage of the ascites from the peritoneal cavity into the superior vena cava using an actively operated pumping mechanism. Use of the pump in the patient abolished the ascites, considerably improved renal function, equilibrated electrolyte metabolism and improved renal response to diuretics.