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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.

Authors

D. Hariharan

Emilie A. Wilkes emilie.wilkes@nuh.nhs.uk

Guruprasad P. Aithal guru.aithal@nottingham.ac.uk

S.J. Travis

Dileep N. Lobo Dileep.lobo@nottingham.ac.uk



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.

Journal Article Type Article
Publication Date May 2, 2017
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
APA6 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), doi:10.1308/rcsann.2017.0058
DOI https://doi.org/10.1308/rcsann.2017.0058
Keywords Peritoneovenous shunt; Thrombosis; Occlusion; Ascites; Chylous
Publisher URL https://publishing.rcseng.ac.uk/doi/10.1308/rcsann.2017.0058
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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