[Treatment of refractory hepatic encephalopathy associated with insertion of a transjugular intrahepatic portosystemic shunt through new endovascular techniques: a case report]

Belén Martínez Moreno; Pablo Bellot; Francisco de España; José María Palazón; José Such; Miguel Pérez-Mateo

doi:10.1016/j.gastrohep.2011.03.021

[Treatment of refractory hepatic encephalopathy associated with insertion of a transjugular intrahepatic portosystemic shunt through new endovascular techniques: a case report]

Gastroenterol Hepatol. 2011 Aug-Sep;34(7):468-73. doi: 10.1016/j.gastrohep.2011.03.021. Epub 2011 Jun 8.

[Article in Spanish]

Authors

Belén Martínez Moreno¹, Pablo Bellot, Francisco de España, José María Palazón, José Such, Miguel Pérez-Mateo

Affiliation

¹ Unidad Hepática, Hospital General y Universitario de Alicante, Alicante, España.

PMID: 21652116
DOI: 10.1016/j.gastrohep.2011.03.021

Abstract

Insertion of a transjugular intrahepatic portosystemic shunt (TIPS) is an increasingly used treatment in the management of the complications of portal hypertension. However, one of the complications of this technique is refractory or recurrent hepatic encephalopathy, which poses a difficult clinical problem. We report the case of a patient who underwent TIPS insertion to control bleeding due to esophageal varices. The patient subsequently developed refractory hepatic encephalopathy, requiring reduction of the caliber of the shunt.

Publication types

Case Reports
English Abstract

MeSH terms

Ascites / drug therapy
Ascites / etiology
Endovascular Procedures / instrumentation
Endovascular Procedures / methods*
Equipment Design
Esophageal and Gastric Varices / etiology
Esophageal and Gastric Varices / surgery
Furosemide / therapeutic use
Gastrointestinal Hemorrhage / etiology
Gastrointestinal Hemorrhage / surgery
Hepatic Encephalopathy / etiology
Hepatic Encephalopathy / surgery*
Humans
Hypertension, Portal / complications
Hypertension, Portal / surgery
Jugular Veins
Liver Circulation
Liver Cirrhosis, Alcoholic / complications
Male
Middle Aged
Polytetrafluoroethylene
Portasystemic Shunt, Transjugular Intrahepatic / adverse effects
Portasystemic Shunt, Transjugular Intrahepatic / instrumentation
Portasystemic Shunt, Transjugular Intrahepatic / methods*
Postoperative Complications / etiology
Postoperative Complications / surgery*
Propranolol / therapeutic use
Reoperation
Spironolactone / therapeutic use
Stents

Substances

Spironolactone
Furosemide
Polytetrafluoroethylene
Propranolol