The ascitic leak: a case presentation. Management by paracentesis and saline--albumin reinfusion

Postoperative ascites, particularly if infected, poses a difficult clinical situation for the surgeon. Concomitant use of salt and water restriction and diuretics will control most cases. However, in those patients who do not respond, paracentesis with a peritoneal dialysis cathether together with concomitant infusions, cubic centimeter for cubic centimeter, of saline-albumin or fresh frozen plasma will insure a sufficient intravascular volume to enable adequate renal perfusion, decrease intra-abdominal pressure to allow adequate respiratory mechanics, and decrease potential losses from around drainage tubes. Thus the cirrhotic patient may recover more easily from the insult of the nonhepatic surgical procedure. A case is presented demonstrating this technique.