Biopsy of the peritoneum in decompensated cirrhosis of the liver.

Fifteen patients with noninfectious chronic ascites due to liver cirrhosis were investigated by laparoscopy and/or peritoneal biopsy. Laparoscopic inspection revealed thickening of the peritoneum, diffuse patchy redness and diffusely increased small vascular injection. Biopsies of the parietal peritoneum showed cuboidal transformation and hyperplasia of the mesothelial cells, fibrinoid depositions, fibroblastic proliferation and mononuclear cell infiltration. Probable pathogenesis of the parietal chronic nonspecific peritonitis in ascites of liver cirrhosis is the presence of irritating substances in the ascitic fluid. Diffuse small vascular injection of the peritoneum reflects most likely the inflammatory nature of the peritoneal process and not a direct influence of portal hypertension.