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Acute liver failure and infarction complicating TIPS placement.
Guo-Ping Liu1, Mei-Ying Zhang2, Rui Xu1
1Department of Interventional Radiology, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China.
Radiology Case Reports
|June 14, 2019
Summary
Transjugular intrahepatic portosystemic shunt (TIPS) can lead to acute liver failure and hepatic infarction. This case highlights a fatal outcome following TIPS in a patient with alcoholic cirrhosis and upper gastrointestinal bleeding.
Area of Science:
- Hepatology
- Interventional Radiology
- Gastroenterology
Background:
- Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure used to reduce portal pressure.
- Alcoholic cirrhosis is a common indication for TIPS, often associated with complications like gastrointestinal hemorrhage.
Observation:
- A patient with alcoholic cirrhosis presented with upper gastrointestinal hemorrhage and underwent TIPS.
- Post-procedure, the patient developed rapidly rising liver enzymes (ALT, AST) and signs of hepatic infarction.
- Imaging revealed diffuse hepatic parenchyma changes, hypodense lesions, and pleural effusion.
Findings:
- The patient experienced acute liver failure and hepatic infarction following TIPS.
- Emergent stent occlusion was performed due to suspected complications.
- Portography confirmed lack of portal vein supply to the right liver lobe.
Implications:
- This case underscores the potential for severe complications, including fatal hepatic infarction, after TIPS.
- Careful patient selection and monitoring are crucial for patients undergoing TIPS, especially those with advanced liver disease.
- Understanding the risks associated with TIPS is essential for managing patients with portal hypertension and its complications.
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