[Recurrent bleeding from colonic varices in portal hypertension. The successful prevention of recurrence by the implantation of a transjugular intrahepatic stent-shunt (TIPS)].
METHODS
Sclerotherapy was performed in a 52-year-old patient with alcoholic liver cirrhosis (Child-Pugh stage A) for recurrent bleeding from oesophageal varices. Half a year later he again was admitted to hospital because of recurrent passage of bloody stools. The cardiovascular status was stable; the liver was enlarged by 15 cm in the medioclavicular line.


METHODS
Endoscopy revealed several varices in the colon near the right flexure. One of the varices had an ulcer of 5 mm size. Duplex sonography revealed portal hypertension with cirrhosis of the liver and partial thrombosis of the main trunk of the portal vein without any sign of cavernous transformation.


METHODS
Because of the partial portal vein thrombosis it was decided to insert a transjugular intrahepatic portosystemic stent shunt. This obviated the thrombosis and lowered the portosystemic pressure gradient by 6.8%. With the shunt functioning well there were no further bleedings in the subsequent year.


CONCLUSIONS
The only slightly invasive TIPS implantation is an effective therapeutic procedure for bleeding from colon varices caused by portal hypertension.
Abteilung Innere Medizin II, Medizinische Universitätsklinik, Freiburg.
H P
HP
Allgaier
A
A
Ochs
K
K
Haag
K H
KH
Hauenstein
W
W
Tittor
M
M
Rössle
H E
HE
Blum
D003106:Colon / Q000098:blood supply*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D007601:Jugular Veins; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D012008:Recurrence; D015607:Stents; D014648:Varicose Veins / Q000150:complications / Q000175:diagnosis / Q000601:surgery*
Rezidivierende Kolonvarizenblutung bei portaler Hypertonie. Erfolgreiche Rezidiv-Prophylaxe durch Implantation eines transjugulären intrahepatischen Stent-Shunts (TIPS).