[Acute gastrointestinal hemorrhage after placement of a peritoneojugular shunt]. 1990

S Gavrilović, and M Fabri, and D Dzambas, and L Gvozdenović, and I Klem
Medicinski fakultet, Institut za hirurgiju, Novi Sad.

Since 1984 the peritoneovenous (LeVeen) shunt has been installed in 33 patients (10 females 30.3%, and 23 males 69.7%), with the average age of 54 +/- 8 years all in the oedema--ascitic decompensation phase of their primary illness. The control group consisted of 39 patients with identical etiology and primary illness stadium, sex and age structure and duration of primary illness, all treated with medicament - diet therapy. All the operated patients and those treated with medicament--diet regime died. Their autopsy findings were confronted. The aim of this study was to indicate the type and frequency of digestive hemorrhage in this population on our own clinical--patient material. Gastrointestinal hemorrhage was the cause of death in 8 (24.24%) patients out of the group operated on, and 6 (15.3%) from the control group. The isolated rupture of esophageal varices was the cause of death in one (3.03%) patient out of the group operated on, and in 5 (12.12%) patients from the control group, the rupture of esophageal varices with toxic vasculitis in 3 (0.09%) patients from the group operated on, and not in one out of the control group; rupture of esophageal varices associated with toxic vasculitis and disorders of the hemostatic mechanism appeared in 4 (12.12%) of patients from the group operated on, and in 1 (2.56%) of the control group. On the basis of the presented it can be concluded that gastrointestinal hemorrhage is a significantly more frequent cause of death in the group operated on than in the control group, and that hemorrhages are of an all the more complex etiology when the flow-in of ascites into circulation is greater. Hemodilution and endotoxins are to blame for their occurrence and it is necessary to preoperatively conduct, beside the control of the hemostatic mechanism, also the test of ones own ascitic burdening and to determine the level of endotoxin in the ascites.

UI MeSH Term Description Entries
D007601 Jugular Veins Veins in the neck which drain the brain, face, and neck into the brachiocephalic or subclavian veins. Jugular Vein,Vein, Jugular,Veins, Jugular
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010536 Peritoneovenous Shunt An operation for the continuous emptying of ascitic fluid into the venous system. Fluid removal is based on intraperitoneal and intrathoracic superior vena cava pressure differentials and is performed via a pressure-sensitive one-way valve connected to a tube traversing the subcutaneous tissue of the chest wall to the neck where it enters the internal jugular vein and terminates in the superior vena cava. It is used in the treatment of intractable ascites. Ascites Shunt, Peritoneovenous,LeVeen Shunt,Peritoneo-Venous Shunt,Ascites Shunts, Peritoneovenous,Peritoneo Venous Shunt,Peritoneo-Venous Shunts,Peritoneovenous Ascites Shunt,Peritoneovenous Ascites Shunts,Peritoneovenous Shunts,Shunt, LeVeen,Shunt, Peritoneo-Venous,Shunt, Peritoneovenous,Shunt, Peritoneovenous Ascites,Shunts, Peritoneo-Venous,Shunts, Peritoneovenous,Shunts, Peritoneovenous Ascites
D004932 Esophageal and Gastric Varices Dilated blood vessels in the ESOPHAGUS or GASTRIC FUNDUS that shunt blood from the portal circulation (PORTAL SYSTEM) to the systemic venous circulation. Often they are observed in individuals with portal hypertension (HYPERTENSION, PORTAL). Esophageal Varices,Gastric Varices,Esophageal Varix,Gastric Varix,Varices, Esophageal,Varices, Gastric,Varix, Esophageal,Varix, Gastric
D005260 Female Females
D006471 Gastrointestinal Hemorrhage Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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