Transjugular intrahepatic portosystemic shunt performed in a 2-year-old infant with uncontrollable intestinal bleeding

J Pediatr Surg. 2000 Nov;35(11):1597-9. doi: 10.1053/jpsu.2000.18324.

Abstract

Although transjugular intrahepatic portosystemic shunt (TIPS) is widely accepted in adults, there have been few successful reports in infants. The authors describe a 2-year-old boy with postoperative biliary atresia who underwent TIPS for uncontrollable lower intestinal bleeding and achieved hemostasis. Massive melena developed, which was not controlled by conservative therapy and devascularization. A shunt was created between the right hepatic vein and the right portal vein with a 6- x 50-mm Wallstent. After TIPS, the porto-systemic pressure gradient decreased from 15 to 11 mm Hg, and collaterals markedly reduced. He has not had recurrent bleeding for over 7 months. TIPS may be a technically feasible and effective treatment to control intestinal bleeding in infants. However, further experience and long-term follow-up will be required.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Biliary Atresia / complications
  • Biliary Atresia / diagnosis
  • Biliary Atresia / surgery
  • Child, Preschool
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / diagnostic imaging
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / surgery*
  • Hemostasis / physiology
  • Humans
  • Hypertension, Portal / complications
  • Hypertension, Portal / diagnosis
  • Hypertension, Portal / surgery
  • Male
  • Portasystemic Shunt, Transjugular Intrahepatic / methods*
  • Portography
  • Severity of Illness Index
  • Treatment Outcome