Successful Treatment of Ascites using a Denver<sup>®</sup> Peritoneovenous Shunt in a Patient with Paroxysmal Nocturnal Hemoglobinuria and Budd-Chiari syndrome

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Author(s)

    • Kogiso Tomomi
    • Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
    • Morita Satoru
    • Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Japan
    • Takahashi Yutaka
    • Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Japan
    • Tanaka Junji
    • Department of Hematology, Tokyo Women's Medical University, Japan
    • Sakai Shuji
    • Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Japan
    • Yamamoto Masakazu
    • Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Japan
    • Tokushige Katsutoshi
    • Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
    • Hashimoto Etsuko
    • Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
    • Ito Taito
    • Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
    • Hara Toshifumi
    • Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
    • Ikarashi Yuichi
    • Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
    • Kodama Kazuhisa
    • Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
    • Taniai Makiko
    • Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
    • Torii Nobuyuki
    • Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan

Abstract

<p>A 56-year-old man was diagnosed with aplastic anemia and paroxysmal nocturnal hemoglobinuria at 43 years of age and treatment with cyclosporin A was started. Liver cirrhosis, ascites, and thrombus in the hepatic veins were found at 56 years of age and Budd-Chiari syndrome (BCS) was diagnosed according to angiography findings. He was treated with diuretics and paracentesis was performed several times, but with limited efficacy. A Denver<sup>®</sup> peritoneovenous shunt (PVS) was inserted into the right jugular vein; his ascites and renal function improved immediately and his general condition has remained good for 12 months since starting the above treatment regimen. A PVS is a treatment option for ascites due to BCS. </p>

Journal

  • Internal Medicine

    Internal Medicine 55(20), 2957-2963, 2016

    The Japanese Society of Internal Medicine

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