Hariharan D, Wilkes E A, Aithal G P, Travis S J, Lobo D N
Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham , UK.
Ann R Coll Surg Engl. 2017 May;99(5):e145-e147. doi: 10.1308/rcsann.2017.0058.
A 43-year-old man had a peritoneovenous shunt inserted for the treatment of chylous ascites secondary to myelofibrosis. Despite being on anticoagulation for superior mesenteric vein thrombosis, he developed shunt dysfunction within two weeks of insertion. Superior venacavography showed multiple filling defects in the right axillary vein, no filling of the right brachiocephalic and right subclavian vein, and thrombotic occlusion of the internal jugular veins bilaterally. The shunt was removed 11 days after insertion, and there was extensive thrombosis of the venous end of the shunt and the compressible pump chamber. Shunt thrombosis is known to occur but remains a rare complication, with 87% of such obstructions being due to a thrombus at the tip of the venous end of the shunt. Extensive thrombosis of the shunt (as in the present case) is very rare.
一名43岁男性因骨髓纤维化继发乳糜性腹水而接受了腹膜静脉分流术。尽管因肠系膜上静脉血栓形成而接受抗凝治疗，但他在分流术插入后两周内出现了分流功能障碍。上腔静脉造影显示右腋静脉有多个充盈缺损，右头臂静脉和右锁骨下静脉未显影，双侧颈内静脉血栓形成闭塞。分流术在插入后11天被移除，分流术静脉端和可压缩泵腔存在广泛血栓形成。已知分流术会发生血栓形成，但仍然是一种罕见的并发症，此类梗阻的87%是由于分流术静脉端尖端的血栓所致。分流术广泛血栓形成（如本例）非常罕见。
