Chylous ascites: resolution after Denver peritoneovenous shunt

Area of Science:

• Gastroenterology
• Surgical Innovation
• Vascular Surgery

Background:

• Chylous ascites is a challenging condition often requiring repeated interventions.
• Warren shunts, used for portal hypertension, can lead to complications like chylous ascites.
• Paracentesis, a common treatment, carries risks of malnutrition and infection.

Observation:

• A patient with chylous ascites secondary to a Warren shunt presented with significant complications.
• A Denver peritoneovenous shunt was surgically placed to manage the refractory chylous ascites.
• The patient was monitored for shunt function and ascites resolution.

Findings:

• The Denver peritoneovenous shunt successfully managed the chylous ascites.
• Spontaneous closure of the chylous peritoneal fistula occurred seven months post-insertion of the Denver shunt.
• This treatment approach prevented the need for further paracentesis.

Implications:

• Peritoneovenous shunting offers a viable alternative for managing complex chylous ascites.
• This strategy mitigates the risks of nutritional compromise and sepsis linked to repeated paracentesis.
• The findings suggest a potential improvement in patient outcomes for chylous ascites management.