The role of lymphatics in the formation of ascites complicating schistosomal hepatic fibrosis.

The total protein content in plasma, ascitic fluid, thoracic duct lymph, hepatic and intestinal lymph was studied in a series of 15 patients suffering from schistosomal hepatic fibrosis and intractable ascites. Pure schistosomal cases with presinusoidal resistance to portal blood flow have excessive thoracic duct lymph low in protein. The main source of such excess lymph is the extra-hepatic portal bed. Ascitic fluid in such patients has a low protein content and has the character of a transudate. The bulk of such peritoneal fluid seems to originate largely from the excess extrahepatic portal lymph.