Peritoneovenous Shunting for Intractable Chylous Ascites Complicated with Lymphangioleiomyomatosis

• Makino Yuko

  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

• Iwase Akihiko

  Departments of Respiratory Medicine, Tokyo Metropolitan Koto Geriatric Medical Center

• Kawasaki Seiji

  Department of Hepatobiliary-Pancreatosurgery, Juntendo University, School of Medicine

• Takahashi Kazuhisa

  Departments of Respiratory Medicine, Juntendo University, School of Medicine

• Seyama Kuniaki

  Departments of Respiratory Medicine, Juntendo University, School of Medicine

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^®) 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

Keywords

• tumor suppressor gene syndrome
• the <i>TSC</i> genes
• lymphangioleiomyoma

Details

• CRID: 1390001204871047808
• NII Article ID: 130000079736
• DOI: 10.2169/internalmedicine.47.0475
• ISSN: 13497235
• ISSN: 09182918
• Web Site: http://www.jstage.jst.go.jp/article/internalmedicine/47/4/47_4_281/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2008244269
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed