Open AccessLiver failure after an uncovered TIPS procedure associated with hepatic infarction
Author(s) -
Eric López-Méndez,
Daniel Zamora-Valdés,
Mariana Díaz-Zamudio,
Oscar F. Fernández-Diaz,
Lourdes Ávila
Publication year - 2010
Publication title -
world journal of hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 55
ISSN - 1948-5182
DOI - 10.4254/wjh.v2.i4.167
Subject(s) - medicine , ascites , cirrhosis , hepatic encephalopathy , transjugular intrahepatic portosystemic shunt , coagulopathy , portal hypertension , liver disease , gastroenterology , liver function , liver function tests , jaundice , surgery
Transjugular intrahepatic portosystemic shunt (TIPS) is a safe and effective procedure for the treatment of complications of liver cirrhosis, such as refractory ascites, hepatic hydrothorax and refractory variceal bleeding. The aim of this paper is to describe a rare case of liver failure after a TIPS procedure. A 38-year-old diabetic male with Child-Pugh C liver cirrhosis due to chronic hepatitis C infection who had developed refractory ascites was scheduled for a TIPS procedure. Within 24 h following TIPS placement, the patient developed distributive shock, jaundice, persistentgrade 3 hepatic encephalopathy, severe coagulopathy and acute renal failure. He was treated with lactulose enemas, broad-spectrum antibiotics and blood-derived products. Laboratory data revealed a 100-fold increase in aminotransferases and a non-enhanced computed tomography showed an irregular hypodense area in the right posterior segment of the liver. Despite being initially being in a stable condition, the patient developed progressive liver failure and died 2 mo later. Hepatic infarction is an uncommon phenomenon after a TIPS procedure; however, it can greatly complicate the course of a disease in a patient with an already compromised liver function.