[Cure of recurrent ascites in alcoholic hepatitis following transient placement of a LeVeen shunt].
Three cases of severe alcoholic hepatitis associated with refractory ascites are reported. A LeVeen shunt was inserted which was effective and well tolerated. However, the shunt was removed in all 3 patients 8 months, 12 months and 9 years after insertion because of spontaneous migration (n = 2) or superior vena cava thrombosis (n = 1). At time of shunt removal all 3 patients had micronodular cirrhosis, but none had recurrent ascites during the 1-3 years of observation and despite the absence of diuretics. The eventual transient aspect of refractory ascites associated with alcoholic hepatitis is discussed, together with the potential beneficial and temporary role of LeVeen shunts in this condition.
Service de médecine B, Centre hospitalier universitaire vaudois, Lausanne.
B
B
Yersin
A
A
Genton
R
R
Mosimann
P
P
Magnenat
D000328:Adult; D001201:Ascites / Q000209:etiology / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006519:Hepatitis, Alcoholic / Q000150:complications*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010536:Peritoneovenous Shunt
Guérison de l'ascite réfractaire dans l'hépatite alcoolique, après mise en place transitoire d'un shunt de LeVeen.