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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.

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


Authors

D. Hariharan

Emilie A. Wilkes

S.J. Travis

DILEEP LOBO dileep.lobo@nottingham.ac.uk
Professor of Gastrointestinal Surgery



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

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