Peritoneovenous Shunt for Intractable Ascites in Children: A Series of 4 Cases. Issue 1 (July 2021)

• Record Type: Journal Article
• Authors: Defert, Coralie; Marret, Jean-Baptiste; Lacaille, Florence; Sissaoui, Samira; Dupic, Laurent; Lardy, Hubert; Capito, Carmen; Chardot, Christophe
• Is Part Of: Journal of pediatric gastroenterology and nutrition. Volume 73:Issue 1(2021)
• Publication Date: 2021-07
• Subjects: ambulance -- cardiac arrest -- emergency medical services -- extracorporeal cardiopulmonary resuscitation -- prehospital -- resuscitation -- termination of resuscitation -- transport; Children -- Nutrition -- Periodicals; Pediatric gastroenterology -- Periodicals; Infants -- Nutrition -- Periodicals; Nutrition disorders in children -- Periodicals; Child Nutrition -- Periodicals; Digestive System -- growth & development -- Periodicals; Gastrointestinal Diseases -- Periodicals; Infant Nutrition -- Periodicals; Nutrition Disorders -- Periodicals; Child; 618.923
• DOI: 10.1097/MPG.0000000000003131
• Languages: English
• ISSNs: 0277-2116

Abstract

Abstract : ABSTRACT: Intractable ascites is a rare condition in children mainly caused by cirrhosis or lymphatic disorders. Internal drainage may be considered as rescue therapy. In our department, 4 patients ages from 2 months to 15 years old underwent a peritoneovenous shunt (PVS) placement between 2010 and 2020. The surgically inserted device was a pumping device that enabled to drain ascites from the peritoneum into the venous system via the internal jugular vein (Denver shunt, BD Company, NJ). Immediate efficient drainage was achieved in all cases and lasted up to 9 years. Two major complications occurred: a postoperative fat embolism requiring urgent temporary ligation of the shunt and endocarditis shortly after inguinal hernia repair performed 16 months after placement of the shunt. Implementation of a PVS may be a useful procedure in patients with refractory ascites. Chylous ascites should be drained and washed totally before activating the device to avoid fat embolism. Antibiotic prophylaxis is required when abdominal surgery is planned while the device is in place.