Transjugular intrahepatic portosystemic shunt in a patient with cavernomatous portal vein occlusion |
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| Authors: | Hiroshi Kawamata MD Tatsuo Kumazaki Hidenori Kanazawa Shuji Takahashi Hiroyuki Tajima Hiromitsu Hayashi |
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| Institution: | (1) Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan, JP;(2) The Third Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan, JP |
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| Abstract: | A 23-year-old woman with liver cirrhosis secondary to primary sclerosing cholangitis was referred to us for the treatment
of recurrent bleeding from esophageal varices that had been refractory to endoscopic sclerotherapy. Her portal vein was occluded,
associated with cavernous transformation. A transjugular intrahepatic portosystemic shunt (TIPS) was performed after a preprocedural
three-dimensional computed tomographic angiography evaluation to determine feasibility. The portal vein system was recanalized
and portal blood flow increased markedly after TIPS. Esophageal varices disappeared 3 weeks after TIPS. Re-bleeding and hepatic
encephalopathy were absent for 3 years after the procedure. We conclude that with adequate preprocedural evaluation, TIPS
can be performed safely even in patients with portal vein occlusion associated with cavernous transformation. |
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| Keywords: | : Liver cirrhosis— Interventional procedure— Portal vein thrombosis— Shunts portosystemic |
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