A 41-year-old woman with liver cirrhosis had recurrent portal hypertension and bleeding from esophageal varices due to complete occlusion of a previously inserted transjugular intrahepatic portosystemic shunt stent. Because recanalization of the stent by the transjugular approach was unsuccessful, ultrasound-guided entry to the splenic vein and portal vein was used. After catheter-directed intr...

The main indication of transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of variceal bleeding and refractory ascites in cirrhotic patients. In the presence of portal vein thrombosis in patients with cirrhosis, the risk of variceal bleeding increases and portal vein access during the procedure can be difficult. Various approaches including transhepatic, trans-splenic approach...

We report in a 65-year-old man hepatocellular carcinoma adjacent to a transjugular intrahepatic portosystemic shunt stent-graft which was successfully treated with irreversible electroporation (IRE). IRE is a new non-thermal tissue ablation technique which uses electrical pulses to induce cell necrosis by irreversible membrane poration. IRE proved to be more advantageous in the ablation of peri...

We report a case of spondylodiscitis caused by multiresistant Serratia marcescens in a cirrhotic patient who had several Serratia bacteremias after the placement of a transjugular intrahepatic portosystemic shunt (TIPS) device. We concluded that an endovascular stent that can not be removed makes management of recurrent bacteremia difficult. Furthermore, back pain due to bacteremia is indicativ...

Patients with Barrett's esophagus (BE) and cirrhosis who develop high-grade dysplasia (HGD) or adenocarcinoma in the setting of esophageal varices present a unique therapeutic dilemma. There is limited literature regarding the optimal management of varices prior to invasive procedures or surgery involving the distal esophagus. We present a case of variceal decompression with a transjugular intr...

If this were not enough, these patients also have pulmonary arterial hypertension (PAH). The coexistence of portal hypertension and PAH frequently makes patients with this rare (or ‘‘orphan’’) condition medical ‘‘untouchables’’. PPHTN patients with progressive hepatic dysfunction and other complications are often deemed to be too ‘‘high-risk’’ for placement of a transjugular intrahepatic portos...

Aim: This evidence-based case report aims to assess the accuracy of EUS-PPG measurement in patients with portal hypertension.Method: A literature search was performed using PubMed, Cochrane, ProQuest, and EBSCO. total 2 articles were selected after meeting inclusion exclusion criteria. Critical study assessment conducted validity, importance, applicability study.Results: As a result, first foun...

A 20-year-old male presented with 2 months of progressive abdominal distension due to ascites and Budd-Chiari syndrome. He underwent transjugular intrahepatic portosystemic shunt (TIPS) placement, but soon after had elevated liver enzymes. MRCP revealed mild left intrahepatic biliary dilatation without stones or obvious stricture. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrat...