Postoperative ascitic leaks: the ongoing challenge.
BACKGROUND
The leak of ascitic fluid from surgical incisions is thought to be associated with a very high mortality rate. There have been few reports, however, focusing on the clinical characteristics, management, or mortality rates of this condition.


METHODS
During a 10-year period, 18 patients with postoperative ascitic fluid leaks were treated. All patients had ascites before surgery and all had liver disease; in 13 of the 18 patients alcoholic liver disease was the cause of ascites.


RESULTS
Ten of the 18 patients died (56%). Midline incisions were more often associated with recalcitrant leaks and fatal complications than were transverse incisions.


CONCLUSIONS
Early consideration of fascial dehiscence and prompt repair is emphasized. The most effective predictor of survival was cessation of the leak.
Rosemurgy
A S
AS
Department of Surgery, University of South Florida, Tampa 33606.
Statman
R C
RC
Murphy
C G
CG
Albrink
M H
MH
McAllister
E W
EW
D001201:Ascites / Q000209:etiology / Q000378:metabolism* / Q000628:therapy; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010539:Permeability; D011183:Postoperative Complications / Q000401:mortality
D004232:Diuretics