LeVEEN Shunt

1. LeVEEN Shunt By: Jose Mongalo

2. OBJECTIVES To provide a brief history of the leveen shunt. To provide advantages and disadvantages of the leveen shunt. To provide a brief detail of when to use a leveen shunt. To provide cases where a leveen shunt has become use full in the operating table. Questions and Answer. Conclusion.

3. HISTORY Since 1945, the medical field has recognized that portocaval shunts, by decompressing the hepatic sinusoid, may improve ascites.

4. Advantages Surgical placement of a Levine shunt) from the abdominal space (peritoneum) to the jugular vein may reduce ascites and reverse some of the symptoms of kidney failure. Treatment is aimed at improving liver function, and ensuring that the amount of blood in the body and the heart pumping action are adequate.

5. disadvantage The Leveen shut is of great value in the world of medicine; However, it has several disadvantages. The performance of a side-to-side portocaval shunt for ascites management must be weighed against the approximate 5% mortality rate associated with this surgery and the chance (as high as 30%) of inducing hepatic encephalopathy (is defined as a spectrum of neuropsychiatric abnormalities in patients with liver dysfunction).

6. Risks There several risks when placing a shunt examples are: Risks for any anesthesia Risks for any surgery are Malfunction or blockage

7. Anesthesia Risk The Patient needs to under go a surgical procedure to place the shunt when they do they are put to sleep under anesthesia some patient may have an allergic reaction to it or others may have breathing problems.

8. Risks for any surgery are  Our body is unique in every way it recognizes what is ours and what is not. In the process of a surgery there is a risk of hemorrhage or bleeding

9. Risk of surgery Previously mentioned our body some times reject what ever foreign objects we may input to it in this case it may be in the form of infections. Symptoms of shunt malfunction or infection include headache , fever , drowsiness , and convulsions .

10. Risk of Malfunction or blockage  The risk of malfunction is based on two things a clog on the shunt it self or a growth factor. The malfunction occurs because the person grows. If this happens the shunt will need to be replaced with a longer catheter.

11. Procedure The abdomen is shaved and scrubbed with soap and antiseptic, and draped so that only the incision region is exposed. The fascia, peritoneum, skin, muscle and fat are cut; vessels which are bleed are tied off and caurerized.

12. Procedure Accumulated fluid is drained from the peritoneum by suction. The LeVeen shunt, with its multitube collecting system, one-way valve, and long upper catheter, is placed into the abdomen and stitched in place.

13. Procedure The upper catheter is run under the skin of the chest to one of the jugular veins, or to the subclavian vein. Then is threaded through a puncture in the vein, and pushed down into the superior vena cava at the point above the heart where blood from the upper body returns to it.

14. Procedure The functioning of the shunt is checked by the injection of tiny or dye radioactive beads. Once verify that the LeVeen shunt is working properly, the abdomen is closed and the individual transferred to the recovery room.

16. Cirrhosis Patient 43 year old male Prognose with cirrhosis due to alcohol drinking 1997 The patient was inplanted a shunt.

17. Outcome 4 weeks after the implantation the patient did not show any complication due to the operation.

18. Ascites In medicine (gastroenterology), ascites (also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more archaically as abdominal dropsy) is an accumulation of fluid in the peritoneal cavity. Although most commonly due to cirrhosis and severe liver disease, its presence can portend other significant medical problems.

19. Ascites This is a CT Scan of the previous patient the patient the later of ascitic fluid between the abdominal wall and liver.

20. Ascites The LeVeen shunt is probably best used in refractory patients who do not respond to serial therapeutic paracentesis and are not candidates for liver transplant.

21. Conclusion Even thought the Leveen shunt is a great asset to the medical doctors there is always risk that. . Because of this procedure is leading to high rate of early complications, the person is usually kept in intensive care for a few days. This procedure is done by a vascular surgeon, neurosurgeon or a general surgeon in a hospital.

22. Questions Name a medical illness that may need the intervention of a LeVeen Shunt? To what vein is the LeVeen shunt connected to?

23. Questions Name the location of the ascetic fluid. What kind of imaging is this scan done with?

24. Questions Name a risk that the patient may under go with leveen shunt implantation.

25. Answers Ascites, Cirrhosis. Jugular veins, or to the Subclavian vein. Between the abdominal wall and liver. CT Scan. The Risk are. Risks for any anesthesia Risks for any surgery are Malfunction or blockage

26. Word cite http://www.unitedhealthdirectory.com/leveen_shunt-536.html http://www.umecopr.com/pages/medical_surgical/leveen_shunt.html http://www.marylandhiv.com/ency/article/000489trt.htm http://images.ask.com/fr?q=Leveen+Shunt&desturi=http%3A%2F%2Ffaculty.mc3.edu%2Frbenfiel%2FNUR211%2FNutritionassessa%2Fsld028.htm&fm=i&ac=24&ftURI=http%3A%2F%2Fimages.ask.com%2Ffr%3Fq%3DLeveen%2BShunt%26desturi%3Dhttp%253A%252F%252Ffaculty.mc3.edu%252Frbenfiel www.scielo.cl/scielo.php?pid=S0034-9887199900... www.gihealth.com/html/education/ascites. http://www.nym.org/healthinfo/docs/075/doc75ascites.html http://www.emedicine.com/med/topic3183.htm