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

Intern Med. 2016;55(20):2957-2963. doi: 10.2169/internalmedicine.55.7087. Epub 2016 Oct 15.

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.

Publication types

  • Case Reports

MeSH terms

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