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복막 - 대정맥 문합술로 호전을 보인 간성 수흉중
A Case of Hepatic Hydrothorax Treated with Peritoneovenous Shunt
이승은(Seung Eun Lee),정준(Jun Jeong),변흥열(Heung Yeal Byun),한세환(Se Hwan Han),조주영(Joo Young Cho),최동환(Dong Hwan Choi)
UCI I410-ECN-0102-2009-510-004929807

Since the introduction of the LeVeen modification of the peritoneovenous shunting(PVS) in l974, these devices have been placed in a relatively large number of patients. The most common indication has been for medically intractable ascites in the setting of chronic liver disease. The ascites pump is a tubular device for ascitic fluids which allows transfer of fluid from the peritoneal cavity to the venous system, usually via the right external jugular vein. Implantable tubular devices offer another choice to ameliorate ascites, with ascitic fluid being spontaneously and continuously infused into the circulatory system. A 34-year-old female patient with clinical and laboratory evidence of liver cirrhosis was admitted to our hospital due to dyspnea and abdominal distension. A large amount of ascites was noted on physical examination and the right hydrothorax was revealed on the chest X-ray film. In addition to conservative management of ascites, repeated thoracentesis with paracentesis and chemical pleurodesis were performed, but all of these efforts could not relieve her complaint of dyspnea. So, peritoneovenous shunt was performed to resolve the intractable hepatic hydrothorax. After the shunt operation, her complaint of dyspnea was relieved, and the frequency of repeated thoracentesis diminished. However, the patient expired about 11 weeks after tbe shunt operation, and the cause of death was hepatic encephalopathy. In our report, we present a case of peritoneovenous shunting of ascites in a patient with intractable hepatic hydrothorax. This case report suggests that peritoneovenous shunt would be benificial only in carefully selected patients. (Korean J Gastroenterol l995;27:267-272)

[자료제공 : 네이버학술정보]
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