The Superior Vena Cava Syndrome

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Abstract
THE LeVeen peritoneojugular shunt has been proposed for the therapy of ascitic, cirrhotic patients intractable to medical management or with renal insufficiency. Initial reports emphasize its success and its safety,1,2but with wider usage more complications arise.3-6 Report of a Case A 52-year-old truck driver with an eight-year history of alcoholism had abdominal swelling, jaundice, and oliguria of six weeks' duration. A liver biopsy specimen showed alcoholic hepatitis and cirrhosis. After treatment with a sodiumrestricted diet, diuretics, and two large paracenteses, he was transferred to our care with intractable ascites, hepatomegaly, and splenomegaly. Laboratory studies on admission showed the following values: total bilirubin, 2.6 mg/dL; SGOT, 96 units; SGPT, 32 units; serum albumin, 2.5 g/dL; γ-globulin, 1.6 g/dL; prothrombin time, two seconds; BUN, 69 mg/dL; and creatinine, 2.7 mg/dL. We interpreted the renal failure as hepatorenal syndrome. Urinalysis showed specific gravity of 1.021, pH 5.5, no glucose, ketone,

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