To cite: Vamadevan S, Haltmeier T, Groebli Y. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2013008959 DESCRIPTION A 48-year-old woman with a history of longstanding alcohol consumption, arterial hypertension and morbid obesity was admitted to our emergency department due to massive haematochezia and dyspnoea. She was drowsy, tachypneic (28 breath/min) and icter...

Bleeding from anorectal varices can be massive and life-threatening. Punctual separation between hemorrhoids and anorectal varices is important. Numerous treatment options are available for management of bleeding anorectal varices, but none of them has demonstrated definitive efficacy. We report a case of successful transjugular intrahepatic portosystemic shunt in controlling massive recurrent ...

1. Episodic (precipitant-induced) encephalopathy, commonly seen in the hospital setting, where a superimposed event is a key factor. 2. Persistent (chronic) encephalopathy, seen with extensive portal–systemic shunts and after portocaval shunt surgery or placement of transjugular intrahepatic portosystemic shunt (TIPS). 3. Minimal (subclinical) encephalopathy reflects alterations in cognitive fu...

Background and AimsHepatic encephalopathy (HE) is a frequent severe complication in patients after transjugular intrahepatic portosystemic shunt (TIPS) insertion. Yet, risk factors for post-TIPS HE remain poorly defined. Minimal (mHE) well-known factor overt cirrhotic without TIPS. We aimed to evaluate three tools frequently used diagnosing mHE their dynamic changes predictive value TIPS.Patien...

HYPOTHESIS Distal splenorenal shunt (DSRS) is a safe and effective treatment for patients with Child-Pugh class A and B cirrhosis with recurrent variceal hemorrhage after failed transjugular intrahepatic portosystemic shunt. DESIGN Retrospective case review. SETTING Hepatobiliary surgery and liver transplantation department in a tertiary referral medical center. PATIENTS Between August 1,...