An experience with a LeVeen ascites shunt.

A patient with intractable ascites was treated by placement of the LeVeen peritoneovenous shunt. Shunt failure was caused by malpositioning of the venous limb in the inferior vena cava. This was demonstrated by injection of water-soluble contrast material into the venous limb. Revision of the shunt led to diuresis, weight loss, and reduction of ascites. The physiologic process of the LeVeen shunt is reviewed and we suggest placement of a radiopaque marker into the tubing.