Κινητική της αμμωνίας εις το περιτοναϊκόν υγρόν

Abstract

The kinetics of ammonia between blood and peritoneal fluid on 18 patiens was studied. Ten grams of ammonium citrate were given by mouth; the concentrations of ammonia in the blood and in the peritoneal fluid were comprared after determining the values at fixed times. The cases were divided in two groups: group 1, included eight patients with cirrhosis of the liver, group 2, included patients with ascites of other than liver cirrhosis aetiology, five of whom had carcinoma of the liver and'or of the peritoneal, two patients with lymphosarcoma, one with kidneysarcoma (Bour neville Syndrome) and two cases with congestive heart failure. The following conclusions have drawn : 1. The ammonia concentrations in the ascitic fluid of the cirrhotic group (group 1) before ammonium citrate loading was found to be higher than in the blood. 2. The highest concentration of the ammonia in the ascitic fluid was found two hours after loading and fell to the pre-loading level three hours later. 3. The curve formed by the ammonia values and ascitic fluid is similar to that of the blood. 4. The values of blood —and ascitic fluid—ammonia and the respective ourves in cases of cardiac failure resembled those found in cirrhotics. 5. In cases of neoplasms the fluctuations of ammonia concentrations in the blood and in the peritoneal fluid are minimal and the curves are flat. 6. In lymphosarcoma and kidneysarcoma the pre-loading values of blood ammonia are higher than in the peritoneal fluid.7. High concentration of blood and peritoneal fluid ammonia without appreciable fluctuations might suggest liver cancer on cirrhotic substrate.