Abstract | AIM: The aim the study was to review our experience and determine the effectiveness of peritoneovenous shunts in the management of persistent ascites. METHODS: A retrospective review of all patients who had a peritoneovenous shunt inserted for persistent ascites in our institution over 32 years (1977-2010) was performed. RESULTS: Thirty-one peritoneovenous shunts were inserted into 25 patients. Records from 22 were available. Median age was 34 months (range, 1 month-12 years), with median duration of ascites of 1.75 months (range, 3 weeks-2.5 years). Sixteen had previous abdominal surgery, whereas one had previous thoracic surgery. Other underlying pathologies included hepatitis (n = 2), lymphohistiocytosis, lymphatic hypoplasia, and carcinomatosis. One was regarded as idiopathic. Previous management consisted of paracentesis (n = 15), dietary modification (n = 11), diuretics (n = 9), and total parenteral nutrition (TPN) (n = 4). One underwent fetal drainage of ascites. No intraoperative complications occurred. Eight (36%) had postoperative complications, including shunt occlusion (n = 2), pulmonary edema (n = 2), infection (n = 2), and wound leakage (n = 1). One developed a varix following shunt removal. The ascites resolved after shunting in 20 (91%) of the 22 children. Four died from their underlying pathology. In children with malignancy, the shunt allowed prompt resumption in treatment schedule. CONCLUSION: This represents the largest series of children receiving peritoneovenous shunt for persistent ascites. It is a safe and effective treatment which should be considered early.
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Authors | Nisha Rahman, Paolo De Coppi, Joe Curry, David Drake, Lewis Spitz, Augustino Pierro, Edward Kiely |
Journal | Journal of pediatric surgery
(J Pediatr Surg)
Vol. 46
Issue 2
Pg. 315-9
(Feb 2011)
ISSN: 1531-5037 [Electronic] United States |
PMID | 21292080
(Publication Type: Comparative Study, Journal Article)
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Copyright | Copyright © 2011. Published by Elsevier Inc. |
Topics |
- Ascites
(surgery)
- Child
- Child, Preschool
- Drainage
(methods)
- Female
- Humans
- Infant
- Male
- Peritoneovenous Shunt
(methods)
- Postoperative Complications
(epidemiology)
- Retrospective Studies
- Treatment Outcome
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