Peritoneovenous shunting in intractable ascites

Fourteen patients in whom peritoneovenous shunts were inserted for intractable ascites or malignancy were reviewed. Reduction in ascites was obtained in all patients by the time of discharge with significant diuresis and weight loss. Significant decrease in haemoglobin, packed cell volume, platelet count and prothrombin time also occurred. Coagulation studies were abnormal in 60 per cent of patients in whom they were performed with bruising or detectable bleeding occurring in 28.5 per cent of all patients. Late blockage of the shunt occurred in five patients and was less frequent in Denver than in Le Veen type shunts. Cumulative mortality one month after shunt insertion was 28.5 per cent and at one year was 78.5 per cent reflecting the severity of the underlying disease. Peritoneovenous shunting should be reserved for palliation in patients resistant to full conventional medical therapy.