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Open Access Correspondence

Quantitative modeling of the physiology of ascites in portal hypertension

David G Levitt1* and Michael D Levitt2

Author Affiliations

1 Department of Integrative Biology and Physiology, University of Minnesota, 6-125 Jackson Hall, 321 Church St. S. E., Minneapolis, MN 55455, USA

2 Research Service, Veterans Affairs Medical Center, VAMC/111D, 1 Veterans Drive, Minneapolis, MN 55417, USA

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BMC Gastroenterology 2012, 12:26  doi:10.1186/1471-230X-12-26

Published: 27 March 2012

Abstract

Although the factors involved in cirrhotic ascites have been studied for a century, a number of observations are not understood, including the action of diuretics in the treatment of ascites and the ability of the plasma-ascitic albumin gradient to diagnose portal hypertension. This communication presents an explanation of ascites based solely on pathophysiological alterations within the peritoneal cavity. A quantitative model is described based on experimental vascular and intraperitoneal pressures, lymph flow, and peritoneal space compliance. The model's predictions accurately mimic clinical observations in ascites, including the magnitude and time course of changes observed following paracentesis or diuretic therapy.

Keywords:
Ascites; Cirrhosis; Portal hypertension; Wedge pressure