title: Intestinal varices: treatment with the transjugular intrahepatic portosystemic shunt.
abstract: OBJECTIVE
  To perform a retrospective evaluation of transjugular intrahepatic portosystemic shunt (TIPS) placement for treatment of intestinal varices.
  
  
  METHODS
  TIPS were placed in nine patients (six women and three men, aged 36-85 years [mean, 64 years]) with small- (n = 6) and large- (n = 3) intestinal varices. Six patients were actively bleeding at the time of shunt placement. One patient with colon cancer underwent prophylactic TIPS placement for variceal decompression before colectomy.
  
  
  RESULTS
  The mean preprocedure portosystemic gradient of 26.8 mm Hg +/- 5.1 was reduced to 8.8 mm Hg +/- 2.9. Bleeding was controlled in all but one case, in which supplemental variceal embolization was required. Two patients died within 5 days of TIPS placement of preexisting multisystem failure. Three patients died of unrelated causes at 2, 6, and 7 months. The remaining patients were alive an average of 15 months after TIPS placement. There was no recurrent bleeding in any case.
  
  
  CONCLUSIONS
  TIPS placement is an effective method of decompressing intestinal varices.
authors.affiliation: Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Haskal
authors.forename: M
authors.initials: M
authors.lastname: Scott
authors.forename: R A
authors.initials: RA
authors.lastname: Rubin
authors.forename: C
authors.initials: C
authors.lastname: Cope
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D014648:Varicose Veins / Q000209:etiology / Q000601:surgery*