Peritoneovenous shunt for chylous ascites after lung transplantation for lymphangioleiomyomatosis.
A 37-year-old woman with lymphangioleiomyomatosis (LAM) who underwent right single-lung transplantation from a cadaveric donor developed persistent chylous ascites. Despite use of diuretics and sirolimus to reduce ascites-associated symptoms and to prevent gastroesophageal reflex triggered by increased abdominal pressure, the ascites were refractory, and periodic paracenteses were required. With placement of a peritoneovenous shunt (Denver shunt), the patient's abdominal circumference decreased, and her symptoms abated. Thus, placement of a peritoneovenous shunt can be an effective management strategy for refractory chylous ascites in patients with LAM, even after lung transplantation.
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
T
T
Kanou
T
T
Nakagiri
M
M
Minami
M
M
Inoue
Y
Y
Shintani
M
M
Okumura
D000328:Adult; D002915:Chylous Ascites / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016040:Lung Transplantation / Q000009:adverse effects*; D018192:Lymphangioleiomyomatosis / Q000601:surgery*; D019152:Paracentesis; D010536:Peritoneovenous Shunt; D020123:Sirolimus / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D004232:Diuretics; D007166:Immunosuppressive Agents; D020123:Sirolimus