Peritoneovenous shunt for hydrothorax associated with ascites

Two patients with massive hydrothorax associated with ascites resistant to intensive long-term medical management were treated by insertion of a peritoneovenous (LeVeen) shunt. In each case the effusion was resolved within one month after insertion. With one revision each, the two shunts have remained clear for nine and 18 months. The peritoneovenous shunt is an alternative to medical therapy for large effusions. Its effectiveness in resolving them supports the idea that diaphragmatic defects help cause their formation.