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Endotipsitis as an indication for pediatric liver transplantation
Author(s) -
Juamperez Javier,
Quintero Jesús,
Muntaner Antoni,
Pérez Mercedes,
Len Oscar,
Charco Ramón
Publication year - 2019
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13097
Subject(s) - medicine , biliary atresia , liver transplantation , transjugular intrahepatic portosystemic shunt , portal hypertension , surgery , portosystemic shunt , complication , enterobacter cloacae , stent , antibiotics , transplantation , intravenous antibiotics , cirrhosis , klebsiella pneumoniae , biochemistry , chemistry , escherichia coli , biology , gene , microbiology and biotechnology
Endotipsitis is a rare but severe complication of transjugular intrahepatic portosystemic shunt (TIPS), a device widely used to treat portal hypertension in adults, but sparsely used in children. We report a case of endotipsitis in a 3‐year‐old child affected of biliary atresia. She underwent a Kasai procedure at 3 months of age but, although the bile flow was restored, she presented upper gastrointestinal bleeding due to portal hypertension 1.5 years later. A TIPS was placed in order to control the hemorrhage. A year after TIPS placement, she started presenting repeated episodes of cholangitis. Blood cultures were positive to Enterobacter cloacae . Even with long antibiotic courses, adjusted to blood cultures, infectious signs were observed after antibiotic withdrawal. Device infection was demonstrated through Positron emission tomography‐Computed tomography scan. The patient was listed for liver transplantation, and intravenous antibiotic treatment was maintained until stent removal during the liver transplant 8 months later. No infectious complications were demonstrated after the surgery. To the best of our knowledge, this is the first case report of endotipsitis described in a pediatric patient.