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.
A peritoneovenous shunt refers to the surgical insertion of a shunting tube to achieve the continuous emptying of ascitic fluid into the venous system.
Ascites is a serious medical disorder characterized by the pathological accumulation of fluid in the peritoneal cavity, the smooth membrane that lines the cavity of the abdomen and surrounds the organs. Ascites is usually related to acute and chronic liver disease (cirrhosis) and to a lesser degree, to malignant tumors arising in the ovary, colon, or breast. Ascites may also be associated with chronic kidney disease and congestive heart failure. The formation of ascitic fluid results from the interplay of three factors: abnormally high pressure within the liver or the veins draining into the liver (portal hypertension); abnormally low amounts of albumin in the blood (hypoalbuminemia); and changes in sodium and water excretion by the kidneys.
When medical therapy fails, peritoneovenous shunts help manage chronic ascites.