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An experience with a LeVeen ascites shunt.
Archives of Surgery (Chicago, Ill. : 1960)
|March 1, 1976
Summary
LeVeen peritoneovenous shunt failure due to malpositioning was successfully treated with revision. This case highlights the importance of accurate placement for effective ascites management.
Area of Science:
- Medical Devices
- Surgical Procedures
- Gastroenterology
Background:
- Intractable ascites management often requires peritoneovenous shunting.
- The LeVeen peritoneovenous shunt is a common device for treating refractory ascites.
- Proper placement is critical for shunt function and patient outcomes.
Observation:
- A patient presented with intractable ascites unresponsive to conventional treatments.
- LeVeen shunt placement was performed, but symptoms persisted, indicating shunt failure.
- Radiographic contrast study revealed malpositioning of the venous limb within the inferior vena cava.
Findings:
- Shunt malpositioning in the inferior vena cava was the cause of device failure.
- Surgical revision of the LeVeen shunt corrected the malpositioning.
- Post-revision, the patient experienced significant diuresis, weight loss, and ascites reduction.
Implications:
- Accurate surgical placement of peritoneovenous shunts is crucial for efficacy.
- Radiographic confirmation of shunt limb position is recommended to prevent or diagnose malpositioning.
- Consideration of adding radiopaque markers to shunt tubing may improve intraoperative placement and postoperative assessment.