Successful Treatment of Ascites using a Denver® Peritoneovenous Shunt in a Patient with Paroxysmal Nocturnal Hemoglobinuria and Budd-Chiari syndrome.

Abstract

A 56-year-old man was diagnosed with aplastic anemia and paroxysmal nocturnal hemoglobinuria at 43 years of age and treatment with cyclosporin A was started. Liver cirrhosis, ascites, and thrombus in the hepatic veins were found at 56 years of age and Budd-Chiari syndrome (BCS) was diagnosed according to angiography findings. He was treated with diuretics and paracentesis was performed several times, but with limited efficacy. A Denver® peritoneovenous shunt (PVS) was inserted into the right jugular vein; his ascites and renal function improved immediately and his general condition has remained good for 12 months since starting the above treatment regimen. A PVS is a treatment option for ascites due to BCS.

• Authors: Tomomi Kogiso, Etsuko Hashimoto, Taito Ito, Toshifumi Hara, Yuichi Ikarashi, Kazuhisa Kodama, Makiko Taniai, Nobuyuki Torii, Kentaro Yoshinaga, Satoru Morita, Yutaka Takahashi, Junji Tanaka, Shuji Sakai, Masakazu Yamamoto, Katsutoshi Tokushige
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) 2016 Vol. 55 Issue 20 Pg. 2957-2963 ISSN: 1349-7235 [Electronic] Japan
• PMID: 27746432 (Publication Type: Case Reports, Journal Article)

Topics

• Anemia, Aplastic (complications)
• Ascites (complications, surgery)
• Budd-Chiari Syndrome (complications, surgery)
• Hemoglobinuria, Paroxysmal (complications, surgery)
• Humans
• Liver Cirrhosis (complications)
• Male
• Middle Aged
• Peritoneovenous Shunt
• Treatment Outcome
• Venous Thrombosis (complications, surgery)