Long-term outcome after orthotopic heart transplant is often critical in patients with long-persisting right-sided heart failure and consecutive ascites. Transjugular intrahepatic portosystemic stent shunt is an effective treatment for chronic ascites. However, a case of transjugular intrahepatic portosystemic stent shunt implantation after orthotopic heart transplant and left ventricular assis...

Teaching point: Extrahepatic portosystemic shunt is a rare congenital condition, associated with other anomalies, for which prompt radiological diagnosis and treatment are important to prevent complications.

OBJECTIVE To report a patient with prenatal diagnosis of portosystemic shunt; a rare condition in humans. CASE DESCRIPTION 17-day-old female infant admitted for investigation of suspected diagnosis of portosystemic shunt, presumed in obstetric ultrasound. The hypothesis was confirmed after abdominal angiography and liver Doppler. Other tests such as echocardiography and electroencephalogram w...

1 Alberts WM, Salem AJ, Solomon DA, Boyce G. Hepatic hydrothorax: cause and management. Arch Intern Med 1991; 151:2383-88 2 Rubinstein D, McInnes IE, Dudley FJ. Hepatic hydrothorax in the absence of clinical ascites: diagnosis and management. Gastroenterology 1985; 88:188-91 3 Noeldge G, Haah K, Sellinger M, Ochs A, Roessle M. Treatment of portal hypertension with the transjugular intrahepatic ...

We reported the case of a patient in whom severe, and ultimately fatal, pulmonary hypertension developed 1.5 yrs after transjugular intrahepatic portosystemic shunt (TIPS). Pulmonary artery pressures were not affected by 100% oxygen, prostacyclin or nifedipine. Postmortem examinations showed pulmonary and vascular abnormalities typical of pulmonary hypertension. Pulmonary artery pressures shoul...

Parkinsonism and portosystemic encephalopathy (PSE) are cerebral disorders associated with motor and neuropsychological dysfunctions that may occur in patients with chronic liver disease. We describe a patient with parkinsonism and neuroradiologic and 1H spectroscopic findings of PSE associated with a large congenital intrahepatic portosystemic venous shunt. Chronic liver disease was absent. Af...

Balloon-occluded retrograde transvenous obliteration (BRTO) has become a common and effective procedure for treating hepatic encephalopathy due to a portosystemic shunt related to cirrhosis of the liver. However, this method of treatment has rarely been reported in patients after liver transplantation. Here, we report the case of a 52-year-old patient who underwent living donor liver transplant...

BACKGROUND Liver functions and portosystemic collaterals influence the development and severity of hepatic encephalopathy (HE) in cirrhosis. However, it has not been examined which factor has a greater influence or if shunts can be used to determine the presence and severity of HE. The expression of tumor necrosis factor-α (TNF-α) is increased in cirrhosis, and its role in HE deserves further e...

Non-alcoholic fatty liver disease (NAFLD) is a poorly understood multifactorial pandemic disorder. One of the hallmarks of NAFLD, hepatic steatosis, is a common feature in canine congenital portosystemic shunts. The aim of this study was to gain detailed insight into the pathogenesis of steatosis in this large animal model. Hepatic lipid accumulation, gene-expression analysis and HPLC-MS of neu...

Congenital portosystemic shunts are developmental anomalies of the splanchnic vascular system that cause portal blood to bypass the liver. Large-breed dogs are predisposed for intrahepatic portosystemic shunts (IHPSS) and small-breed dogs for extrahepatic portosystemic shunts (EHPSS). While the phenotype resulting from portal bypass of the liver of the two types of shunt is identical, the genot...