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Tips for TIPS: A combined percutaneous and transjugular approach for intrahepatic portosystemic shunt placement after liver transplant
- Source :
- Annals of Hepatology, Vol 22, Iss, Pp 100162-(2021)
- Publication Year :
- 2019
-
Abstract
- A 39-year-old female, liver transplanted for Autosomic Dominant Polycystic Kidney Disease (ADPKD) developed refractory ascites early after surgery, with frequent need of large-volume paracentesis. This was associated with severe sarcopenia and kidney impairment. Liver biopsy showed a sinusoidal congestion with a significant enlargement of hepatic portal veins. This picture suggested the diagnosis of vascular obstructions. Due to an unfavorable passage through the piggy-back surgical anastomosis and the angle between the hepatic veins and the portal branches, a conventional placement of a transjugular portosystemic shunt (TIPS) was not feasible. An alternative approach was pursued with success, using a combined percutaneous-transjugular approach and achieving a complete recovery of ascites, sarcopenia and renal function.
- Subjects :
- Adult
medicine.medical_specialty
Sarcopenia
medicine.medical_treatment
Autosomal dominant polycystic kidney disease
Specialties of internal medicine
Liver transplantation
Transjugular intrahepatic portosystemic shunt
03 medical and health sciences
Surgical anastomosis
0302 clinical medicine
Postoperative Complications
Ascites
Hypertension, Portal
medicine
Paracentesis
Humans
Hepatology
medicine.diagnostic_test
business.industry
General Medicine
medicine.disease
Polycystic Kidney, Autosomal Dominant
Surgery
Settore MED/18
RC581-951
030220 oncology & carcinogenesis
Liver biopsy
030211 gastroenterology & hepatology
Female
Portosystemic shunt
medicine.symptom
Portasystemic Shunt, Transjugular Intrahepatic
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Annals of Hepatology, Vol 22, Iss, Pp 100162-(2021)
- Accession number :
- edsair.doi.dedup.....66ad42c35d97e6226d25399caa1f362d