Chiu K W, Changchien C S, Liaw Y F, Yang S S
Liver Unit, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan, Republic of China.
Hepatogastroenterology. 2000 Nov-Dec;47(36):1700-2.
BACKGROUND/AIMS: To ascertain the mechanism of development of ascites and the hemodynamic change of portal system, 28 patients who had an episode of severe viral hepatitis with and without spontaneous bacterial peritonitis were studied.
By means of a non-invasive duplex system, the relationships between the albumin gradient of serum-ascites and the portal vein velocity were assessed in 10 patients with spontaneous bacterial peritonitis and 18 patients without spontaneous bacterial peritonitis.
In the group of patients with severe form of hepatitis but without spontaneous bacterial peritonitis, there is a significant positive linear correlation between the level of serum albumin and the albumin gradient of serum-ascites (P < 0.001). However, a receded linear correlation was found between the serum albumin and the portal vein velocity (P < 0.02), and between the albumin gradient of serum-ascites and the portal vein velocity (P < 0.027) with Spearman linear correlation analysis.
The present study suggests that hypoalbuminemia may be related to impairment of synthesis function in severe hepatitis itself, but not to the intraabdominal shifting of protein. Decreased portal vein velocity may be the first presenting sign in patients with severe form hepatitis complicating simple ascites. Yet this relationship will be masked and complicated once spontaneous bacterial peritonitis occurs.
