الفهرس 
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Abstract
Twenty patients with refractory ascites were treated by massive diuretics therapy for more than two years with no response to this (medical treatment, undergoing the peritoneo-venous shunt to treat this refractory ascites and present the complications of massive diuretics therapy as biochemical abnormalities, hepatic encephalopathy and other complications. All patients subjected for thorough history taking and complete clinical examination for liver, spleen, ascites, oedema lower limbs and abdominal collaterals, All patiellts subjected to thejollowillg:* Laboratory investigations like:- - Prothrombine time. - Liver function tests including serum bilirubin, albumin, total protein, SOOT, SOPT, sennn alkaline phosphatase. * Kidney function tests (serum creatinine). * Complete blood picture. * Radiological investigations including:- AbdOlninal ultrasonography.