TIPS: a new therapy for esophageal variceal bleeding caused by EHBA.
Clinical and procedural experience using transjugylar intrahepatic portosystemic shunt (TIPS) on 7 children with recurrent hemorrhage of esophageal varices is reported. Recurrent hemorrhage from esophageal varices following repeated paravasal sclerosing of the varices as well as severe-grade hypersplenism are proposed as the indication for its use. The technical details of TIPS, observed and possible early and late complications, the demand for a decrease in the portosystemic pressure gradient to less than 15 mmHg and the influence of TIPS on improvement of the varices, hypersplenism and the frequently observed malabsorption are described.
Schweizer
P
P
Department of Pediatric Surgery, University of Tübingen, Germany.
Brambs
H J
HJ
Schweizer
M
M
Astfalk
W
W
D000293:Adolescent; D001656:Biliary Atresia / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D008297:Male; D011170:Portasystemic Shunt, Surgical; D015607:Stents