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

• Published in: Internal Medicine Vol. 55; no. 20; pp. 2957 - 2963
• Main Authors: Kogiso, Tomomi, Hashimoto, Etsuko, Ito, Taito, Hara, Toshifumi, Ikarashi, Yuichi, Kodama, Kazuhisa, Taniai, Makiko, Torii, Nobuyuki, Yoshinaga, Kentaro, Morita, Satoru, Takahashi, Yutaka, Tanaka, Junji, Sakai, Shuji, Yamamoto, Masakazu, Tokushige, Katsutoshi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2016
• Subjects: Anemia, Aplastic - complications; Ascites - complications; Ascites - surgery; Budd-Chiari syndrome (BCS); Budd-Chiari Syndrome - complications; Budd-Chiari Syndrome - surgery; Case Report; Denver peritoneovenous shunt (PVS); Hemoglobinuria, Paroxysmal - complications; Hemoglobinuria, Paroxysmal - surgery; Humans; Liver Cirrhosis - complications; Male; Middle Aged; paroxysmal nocturnal hemoglobinuria (PNH); Peritoneovenous Shunt; Treatment Outcome; Venous Thrombosis - complications; Venous Thrombosis - surgery
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.55.7087

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.