Disseminated intravascular coagulation. Complication of LeVeen peritoneovenous shunts

R. G. Lerner, J. C. Nelson, P. Corines and L. R. del Guercio

Disseminated intravascular coagulation (DIC) occurred in three of five patients after insertion of a LeVeen shunt for intractable ascites. Four episodes of DIC in these patients ranged in severity from progressive and life-threatening to transient and asymptomatic. Interruption of the shunt in two patients stopped the DIC. Careful monitoring for DIC following shunt insertion allows rational decisions to protect the patient against life-threatening hemorrhage or thrombosis. Disseminated intravascular coagulation occurred in two patients during a trial intravenous infusion of ascites and occurred in one patient even when the surgical procedure was modified to minimize the volume and rate of the infused ascites.