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[The transjugular intrahepatic portosystemic shunt]
J M Pisco1, J M Martins, V Garcia
1Serviço de Radiologia, Hospital de Santa Marta, Lisboa.
Acta Medica Portuguesa
|March 1, 1994
Summary
A transjugular intrahepatic portosystemic shunt effectively treated recurrent esophageal varices bleeding and ascites in a patient with portal hypertension. The procedure resolved symptoms, preventing further hemorrhage and fluid buildup.
Area of Science:
- Hepatology
- Interventional Radiology
- Gastroenterology
Background:
- Portal hypertension is a serious complication of liver disease, often leading to esophageal varices and ascites.
- Esophageal varices pose a significant risk of life-threatening hemorrhage.
- Endoscopic sclerotherapy is a common treatment but may have limited long-term efficacy for severe cases.
Observation:
- A 66-year-old woman presented with recurrent esophageal varices hemorrhage and ascites secondary to portal hypertension.
- Four sessions of endoscopic sclerotherapy failed to prevent recurrent bleeding.
- A transjugular intrahepatic portosystemic shunt (TIPS) procedure was performed.
Findings:
- Following the TIPS procedure, the patient experienced no further esophageal hemorrhage over a 10-month follow-up period.
- The ascites resolved completely after the intervention.
- The transjugular intrahepatic portosystemic shunt remained patent throughout the observation period.
Implications:
- Transjugular intrahepatic portosystemic shunt (TIPS) offers a viable and effective treatment option for managing refractory esophageal varices bleeding and ascites in portal hypertension.
- This case highlights the potential of TIPS as a life-saving intervention when less invasive methods fail.
- Further research into long-term outcomes and patient selection for TIPS in this context is warranted.