Peritoneovenous Shunting for Intractable Chylous Ascites Complicated with Lymphangioleiomyomatosis

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Author(s)

    • Makino Yuko
    • Departments of Respiratory Medicine, Juntendo University, School of Medicine
    • Iwase Akihiko
    • Departments of Respiratory Medicine, Tokyo Metropolitan Koto Geriatric Medical Center
    • Kawasaki Seiji
    • Department of Hepatobiliary-Pancreatosurgery, Juntendo University, School of Medicine
    • Seyama Kuniaki
    • Departments of Respiratory Medicine, Juntendo University, School of Medicine
    • Shimanuki Yuri
    • Departments of Respiratory Medicine, Juntendo University, School of Medicine
    • Fujiwara Noriko
    • Department of Hepatobiliary-Pancreatosurgery, Juntendo University, School of Medicine
    • Morio Yoshiteru
    • Departments of Respiratory Medicine, Juntendo University, School of Medicine
    • Sato Koichi
    • Departments of Respiratory Medicine, Juntendo University, School of Medicine
    • Yoshimoto Jiro
    • Department of Hepatobiliary-Pancreatosurgery, Juntendo University, School of Medicine
    • Gunji Yoko
    • Departments of Respiratory Medicine, Juntendo University, School of Medicine
    • Suzuki Tsutomu
    • Departments of Respiratory Medicine, Juntendo University, School of Medicine
    • Sasaki Shin-ichi
    • The First Division of Internal Medicine, Urayasu Juntendo University Hospital

Abstract

A 38-year-old woman was admitted due to lymphangioleiomyomatosis (LAM)-associated massive chylous ascites and progressive cachexia. She was incidentally diagnosed to have ascites during her regular physical check-up two years previously and LAM was revealed as its underlying cause. Periodic paracentesis was required to ameliorate ascites-associated symptoms, but resulted in lymphocytopenia, malnutrition, and deterioration of general status. Ascites was refractory to diuretics and fat-restricted diet. Peritoneovenous shunt (Denver shunt<sup>®</sup>) was placed and thereafter ascites has been managed successfully without any complications for one year after the placement. Peritoneovenous shunt should be considered in LAM patients whose chylous ascites can not be managed with conservative treatments.<br>

Journal

  • Internal Medicine

    Internal Medicine 47(4), 281-285, 2008

    The Japanese Society of Internal Medicine

Cited by:  2

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