Peritoneovenous Shunting for Intractable Chylous Ascites Complicated with Lymphangioleiomyomatosis
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概要
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A 38-year-old woman was admitted due to lymphangioleiomyomatosis (LAM)-associated massive chylous ascites and progressive cachexia. She was incidentally diagnosed to have ascites during her regular physical check-up two years previously and LAM was revealed as its underlying cause. Periodic paracentesis was required to ameliorate ascites-associated symptoms, but resulted in lymphocytopenia, malnutrition, and deterioration of general status. Ascites was refractory to diuretics and fat-restricted diet. Peritoneovenous shunt (Denver shunt®) was placed and thereafter ascites has been managed successfully without any complications for one year after the placement. Peritoneovenous shunt should be considered in LAM patients whose chylous ascites can not be managed with conservative treatments.
著者
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Seyama Kuniaki
Department Of Respiratory Medicine
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Kawasaki Seiji
Department Of Electrical Engineering Osaka University
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Morio Yoshiteru
Department Of Respiratory Medicine Juntendo University School Of Medicine
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IWASE Akihiko
Department of Infectious and Respiratory Medicine, Showa General Hospital
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Yoshimoto Jiro
Department Of Hepatobiliary-pancreatic Surgery Juntendo University School Of Medicine
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Fujiwara Noriko
Department Of Biochemistry Osaka University Graduate School Of Medicine
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Sato Koichi
Department Of Artificial Organs National Cardiovascular Center Research Institute
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Takahashi Kazuhisa
Department Of Applied Chemistry Faculty Of Science Science University Of Tokyo
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Suzuki Tsutomu
Department Of Applied And Environmental Chemistry Kitami Institute Of Technology
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Fujiwara Noriko
Department of Hepatobiliary-Pancreatosurgery, Juntendo University, School of Medicine
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Iwase Akihiko
Departments of Respiratory Medicine, Tokyo Metropolitan Koto Geriatric Medical Center
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Shimanuki Yuri
Departments of Respiratory Medicine, Juntendo University, School of Medicine
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Makino Yuko
Departments of Respiratory Medicine, Juntendo University, School of Medicine
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Gunji Yoko
Departments of Respiratory Medicine, Juntendo University, School of Medicine
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Sasaki Shin-ichi
The First Division of Internal Medicine, Urayasu Juntendo University Hospital
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Gunji Yoko
Department of Respiratory Medicine, Juntendo University School of Medicine
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Seyama Kuniaki
Departments of Respiratory Medicine, Juntendo University, School of Medicine
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Sato Koichi
Departments of Respiratory Medicine, Juntendo University, School of Medicine
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