Spontaneous central venous thrombosis and shunt occlusion following peritoneovenous shunt placement for intractable ascites

Hariharan, D.; Wilkes, Emilie A.; Aithal, Guruprasad P.; Travis, S.J.; Lobo, Dileep N.

Abstract

A 43-year-old man had a peritoneovenous shunt inserted for the treatment of chylous ascites secondary to myelofibrosis. Despite being on anticoagulation for superior mesenteric vein thrombosis, he developed shunt dysfunction within two weeks of insertion. Superior venacavography showed multiple filling defects in the right axillary vein, no filling of the right brachiocephalic and right subclavian vein, and thrombotic occlusion of the internal jugular veins bilaterally. The shunt was removed 11 days after insertion, and there was extensive thrombosis of the venous end of the shunt and the compressible pump chamber. Shunt thrombosis is known to occur but remains a rare complication, with 87% of such obstructions being due to a thrombus at the tip of the venous end of the shunt. Extensive thrombosis of the shunt (as in the present case) is very rare.

Citation

Hariharan, D., Wilkes, E. A., Aithal, G. P., Travis, S., & Lobo, D. N. (2017). Spontaneous central venous thrombosis and shunt occlusion following peritoneovenous shunt placement for intractable ascites. Annals of The Royal College of Surgeons of England, 99(5), Article e145-e147. https://doi.org/10.1308/rcsann.2017.0058

• Journal Article Type: Article
• Acceptance Date: Feb 5, 2017
• Publication Date: May 2, 2017
• Deposit Date: Apr 18, 2018
• Publicly Available Date: Apr 18, 2018
• Journal: Annals of the Royal College of Surgeons of England
• Print ISSN: 0035-8843
• Electronic ISSN: 1478-7083
• Publisher: Royal College of Surgeons of England
• Peer Reviewed: Peer Reviewed
• Volume: 99
• Issue: 5
• Article Number: e145-e147
• DOI: https://doi.org/10.1308/rcsann.2017.0058
• Keywords: Peritoneovenous shunt; Thrombosis; Occlusion; Ascites; Chylous
• Public URL: https://nottingham-repository.worktribe.com/output/858391
• Publisher URL: https://publishing.rcseng.ac.uk/doi/10.1308/rcsann.2017.0058