BACKGROUND Various renal manifestations are known to develop in patients with liver disease, including chronic hepatitis and cirrhosis. CASE PRESENTATION We evaluated renal disease in two 47-year-old Japanese men with liver cirrhosis and chronic alcoholism for 34 years and 27 years, respectively. Renal biopsy demonstrated massive wire loop-like deposits in the subendothelial space of the glom...

Portal hypertension (PHT) is associated with hemodynamic changes in intrahepatic, systemic, and portosystemic collateral circulation. Increased intrahepatic resistance and hyperdynamic circulatory alterations with expansion of collateral circulation play a central role in the pathogenesis of PHT. PHT is also characterized by changes in vascular structure, termed vascular remodeling, which is an...

Abstract Transjugular intrahepatic portosystemic shunt (TIPS) and spontaneous shunts (SPSS) may lead to new or worsening hepatic encephalopathy (HE), especially in patients with chronic liver disease. Patients medically refractory HE (rHE) benefit from endovascular interventions. In this review, we briefly describe the post-TIPS SPSS vascular anatomy, pathophysiology, classification, factors as...

Surgery for portal hypertension began in 1877, with Nicolai Vladirmirovich who performed the fi rst portacaval anastomosis. There was little clinical success until Blakemore and Whipple between the 1920’s and 1940’s: the mortality rate ranged from 25-40%. Hepatic encephalopathy was a clinical problem. In 1960, Warren and collegues performed a distal splenorenal shunt, which reduced the incidenc...

 We present an unusual case of extensive avascular malformations (AVMs) causing non-cirrhotic portal hypertension. This phenomenon, though previously described, is a rare clinical entity which, in the setting of life threatening portal hypertension, may require vascular decompression either by surgery or a transjugular intrahepatic portosystemic shunt.

A 56-year-old woman with cirrhosis due to chronic hepatitis C underwent emergent transjugular intrahepatic portosystemic shunt (TIPS) due to a ruptured esophageal varix during esophagogastroduodenoscopy. Following TIPS, the patient experienced a rapid rise in serum bilirubin with no evidence of biliary obstruction or hepatic injury. She was determined to have bilhemia, a rare but serious compli...

TIPS (Transjugular Intrahepatic Portosystemic Shunt) is an effective treatment for portal hypertension. However, during the procedure, respiration, needle pressure, and possibly other factors cause the liver to move. This complicates the procedure since the portal vein is not visible during needle insertion. We present the results of a study of intraoperative liver motion.

Duodenal varices are uncommon causes of gastrointestinal bleeding. In the literature, treatment of duodenal variceal bleeding is limited to case reports and case series. Treatment options are endoscopic, interventional radiologic and surgical modalities. In this article, we presented a case of a successful duodenal variceal bleeding treatment with transjugular intrahepatic portosystemic shunt. ...