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September 1967

Peritoneal Atrial Shunt for Intractable Ascites

Arch Surg. 1967;95(3):369-373. doi:10.1001/archsurg.1967.01330150045007

MECHANICAL means have in the past been tested to drain peritoneal fluid into the venous system1,2 but none has been successful due mainly to a propensity for clotting. The analogous problem of draining cerebrospinal fluid in hydrocephalus has been assisted by insertion of a manually compressable subcutaneous pump in the line which helps to keep the system patent.3,4 Smith reported using such a device for drainage of ascitic fluid in one patient.5 This is a report of the development of a peritoneal-right atrial shunt fitted with a plastic clearing pump that has been used in eight patients.

Description of Device  The shunt has three elements: the intraperitoneal collecting sump, the connecting tubes containing the one-way valves, and the flushing pump. Each has undergone progressive modification during this clinical experience.6,7 The shunt now used is illustrated (Fig 1).

Sump.  —The intraperitoneal collecting device consists of a double

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