Hungarian prevalence data and risk factors seem to be similar to other European countries.

We interpret the higher flow values as a consequence of open AV shunts. This means that AV shunt pathophysiology was present in some of our cases.

BACKGROUND. The accepted pathophysiology of telangiectasias is reflux from superficial or deep veins. There are physical signs and scientific findings that do not fit this theory but support the possibility of arteriovenous (AV) shunt origin. OBJECTIVE. If there is a higher flow in spider veins than in the surrounding skin, it means that AV shunts participate in the circulation of the telangiectasia. On the other hand, slow flow indicates reflux as the etiologic factor. METHOD. Telangiectasias and the surrounding skin of 22 legs of 19 patients were examined with laser-Doppler equipment. RESULTS. The probe over the spider vein found a higher flow value (average 28.2 perfusion units [PU]) than in the surrounding skin (15.6 PU) in 13 limbs, but it was significantly higher only in 5 cases. In 9 limbs, the flow was slower. CONCLUSION. We interpret the higher flow values as a consequence of open AV shunts. This means that AV shunt pathophysiology was present in some of our cases.

SummaryWe report a case of primary chylous ascites in a progressively poor condition with proteinlosing enteropathy, pleural and pericardiac effusion. Therapy: Denver peritoneo- venous shunt was implanted. Three years later the patient became septic and the shunt was removed. Clinical course: Soon after implantation the patient’s condition improved, and in two months he lost 51 kg. After three years fibrinous occlusion of the shunt and sepsis developed. The occlusion could be dissolved with streptokinase. Removing the shunt cured the patient’s septic state. The chylous ascites did not recur. Conclusion: In emergency cases implantation of a peritoneo-venous shunt leads to a rapid relief of the state. Usually this is a palliative treatment, but in this case it gave a final result. Fibrin can deposit on or occlude the drain which can be solved without further complications. If the patient is septic the drain must be removed and the septic state ends.