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Transjugular intrahepatic portosystemic stenting in Portal Hypertensive Gastropathy

Pervez Ashraf1, Ghulam Mujtaba Shah, Hafeezullah Shaikh

  • 1Department of Gastroenterology, Liaquat National Hospital, Karachi. pervez.ashraf@lnh.edu.pk

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|September 5, 2009
PubMed

Insights

Portal Hypertensive Gastropathy (PHG), a rare cause of gastrointestinal bleeding in chronic liver disease (CLD), can be effectively managed. Transjugular intrahepatic portosystemic stenting (TIPSS) significantly reduced PHG symptoms and transfusion needs in a CLD patient.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Interventional Radiology

Background:

  • Portal Hypertensive Gastropathy (PHG) is an uncommon cause of upper gastrointestinal bleeding in patients with Chronic Liver Disease (CLD).
  • Hepatitis C Virus (HCV) is a common etiology for CLD, often leading to complications like PHG.

Observation:

  • A 46-year-old female with HCV-induced CLD presented with chronic melena and coffee-ground vomitings.
  • Esophagogastroduodenoscopy confirmed PHG, and ultrasound indicated underlying CLD.
  • The patient required frequent blood transfusions over six months, with no improvement from propranolol treatment.

Findings:

  • Transjugular intrahepatic portosystemic stenting (TIPSS) was performed.
  • Following TIPSS, there was a notable reduction in the severity of PHG.
  • The patient's reliance on blood transfusions decreased significantly post-TIPSS.

Implications:

  • TIPSS represents a viable therapeutic option for managing refractory PHG in CLD patients.
  • Interventional radiology plays a crucial role in treating complications of portal hypertension.
  • Successful management of PHG can improve patient outcomes and reduce healthcare resource utilization.

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