Peritoneovenous Shunt for Intractable Ascites in Children: A Series of 4 Cases.
Journal
Journal of pediatric gastroenterology and nutrition
ISSN: 1536-4801
Titre abrégé: J Pediatr Gastroenterol Nutr
Pays: United States
ID NLM: 8211545
Informations de publication
Date de publication:
01 07 2021
01 07 2021
Historique:
pubmed:
29
4
2021
medline:
13
7
2021
entrez:
28
4
2021
Statut:
ppublish
Résumé
Intractable ascites is a rare condition in children mainly caused by cirrhosis or lymphatic disorders. Internal drainage may be considered as rescue therapy. In our department, 4 patients ages from 2 months to 15 years old underwent a peritoneovenous shunt (PVS) placement between 2010 and 2020. The surgically inserted device was a pumping device that enabled to drain ascites from the peritoneum into the venous system via the internal jugular vein (Denver shunt, BD Company, NJ). Immediate efficient drainage was achieved in all cases and lasted up to 9 years. Two major complications occurred: a postoperative fat embolism requiring urgent temporary ligation of the shunt and endocarditis shortly after inguinal hernia repair performed 16 months after placement of the shunt. Implementation of a PVS may be a useful procedure in patients with refractory ascites. Chylous ascites should be drained and washed totally before activating the device to avoid fat embolism. Antibiotic prophylaxis is required when abdominal surgery is planned while the device is in place.
Identifiants
pubmed: 33908741
pii: 00005176-202107000-00019
doi: 10.1097/MPG.0000000000003131
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e7-e10Informations de copyright
Copyright © 2021 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Guttman FM, Montupet P, Bloss RS. Experience with peritoneo-venous shunting for congenital chylous ascites in infants and children. J Pediatr Surg 1982; 17:368–372.
Riar S, Warshaw B, Amaral S. Chylous ascites complicating pediatric renal transplantation. Pediatr Nephrol 2012; 27:1397–1399.
Weiser AC, Lindgren BW, Ritchey ML, et al. Chylous ascites following surgical treatment for Wilms tumor. J Urol 2003; 170 (4 Pt 2):1667–1669.
Hussain FF, Meer ZF, Lopez AJ. Peritoneovenous shunt insertion for intractable ascites: a district general hospital experience. Cardiovasc Intervent Radiol 2004; 27:325–328.
Lane E, Hsu E, Murray K. Management of ascites in children. Expert Rev Gastroenterol Hepatol 2015; 9:1–12.
Sabri M, Saps M, Peters JM. Pathophysiology and management of pediatric ascites. Curr Gastroenterol Rep 2003; 5:240–246.
Al-Busafi SA, Ghali P, Deschênes M, et al. Chylous ascites: evaluation and management. ISRN Hepatol 2014; 2014:240473.
Peet MM. Indications for and variations in the technic of Eck fistula. Ann Surg 1914; 60:601–609.
LeVeen HH, Wapnick S, Grosberg S, et al. Further experience with peritoneo-venous shunt for ascites. Ann Surg 1976; 184:574–581.
Lund RH, Moritz MW. Complications of Denver peritoneovenous shunting. Arch Surg 1982; 117:924–928.
Matsufuji H, Nishio T, Hosoya R. Successful treatment for intractable chylous ascites in a child using a peritoneovenous shunt. Pediatr Surg Int 2006; 22:471–473.
Sooriakumaran P, McAndrew HF, Kiely EM, et al. Peritoneovenous shunting is an effective treatment for intractable ascites. Postgrad Med J 2005; 81:259–261.
Herman R, Kunisaki S, Molitor M, et al. The use of peritoneal venous shunting for intractable neonatal ascites: a short case series. J Pediatr Surg 2011; 46:1651–1654.
Pettitt BJ. Use of a modified Denver peritoneovenous shunt in a newborn with intractable ascites. J Pediatr Surg 1992; 27:108–109.
See WA, Kresowik TF, Jochimsen PR. Peritoneal venous shunting for the treatment of lymphatic ascites following retroperitoneal lymph node dissection. Urology 1996; 48:783–785.