Efficacy of peritoneovenous shunt for treating tolvaptan-resistant refractory ascites in a cirrhotic patient with portal vein thrombosis: A case report

Shigeto,Kota; Kawaguchi,Takumi; Niizeki,Takashi; Kunitake,Yasushi; Takedatsu,Hidetoshi; Tonan,Tatsuyuki; Fujimoto,Kiminori; Tanaka,Masatoshi; Abe,Toshi; Naito,Hisanori; Torimura,Takuji

doi:10.3892/ol.2016.4357

May-2016 Volume 11 Issue 5

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May-2016 Volume 11 Issue 5

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Case Report

Efficacy of peritoneovenous shunt for treating tolvaptan-resistant refractory ascites in a cirrhotic patient with portal vein thrombosis: A case report

Authors:
- Kota Shigeto
- Takumi Kawaguchi
- Takashi Niizeki
- Yasushi Kunitake
- Hidetoshi Takedatsu
- Tatsuyuki Tonan
- Kiminori Fujimoto
- Masatoshi Tanaka
- Toshi Abe
- Hisanori Naito
- Takuji Torimura
View Affiliations / Copyright

Affiliations: Department of Medicine, Division of Gastroenterology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan, Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan, Naito Hospital, Kurume, Fukuoka 830‑0038, Japan
Pages: 3205-3209
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Published online on: March 21, 2016

https://doi.org/10.3892/ol.2016.4357
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Abstract

Peritoneovenous shunt is normally used for the treatment of refractory ascites. However, its efficacy in treating tolvaptan-resistant refractory ascites has not been reported thus far. In addition, the impact of peritoneovenous shunt on the prognosis of cirrhotic patients remains controversial. In the present report, a case of tolvaptan-resistant refractory ascites associated with liver cirrhosis and portal vein thrombosis is described. The male patient was diagnosed with hepatitis C virus‑related liver cirrhosis at the age of 51 years. At the age of 56 years, the patient developed portal vein thrombosis, resulting in the development of refractory ascites. Since the ascites was resistant to treatment with a low‑sodium diet and diuretics such as tolvaptan, a peritoneovenous shunt was implanted upon obtaining consent. The shunt immediately increased the urine volume, and the ascites was markedly decreased. The patient's body weight decreased from 62.7 to 57.1 kg in 2 days, and his ascites symptom inventory‑7 score decreased from 23 to 0 points in 31 days. Although the patient succumbed to sepsis on day 486 following the shunt implant, his activities of daily living were preserved until 8 days prior to mortality. Thus, the present case supports the efficacy of peritoneovenous shunt for the treatment of tolvaptan‑resistant refractory ascites associated with liver cirrhosis and portal vein thrombosis. Furthermore, the present case suggests that peritoneovenous shunt may prolong the survival of cirrhotic patents with refractory ascites.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Efficacy of peritoneovenous shunt for treating tolvaptan-resistant refractory ascites in a cirrhotic patient with portal vein thrombosis: A case report

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