Hepatic venoocclusive disease as a complication of whole abdominopelvic irradiation and treatment with the transjuglar intrahepatic portosystemic shunt: case report and literature review.
We report the novel use of the transjugular intrahepatic portosystemic shunt (TIPS) procedure for the treatment of intractable ascites due to hepatic venooclusive disease as a result of whole abdominopelvic radiotherapy. A patient with Stage III endometrioid carcinoma of the endometrium treated with postoperative whole abdominopelvic irradiation developed intractable ascites. Multiple paracenteses and computerized tomography were negative for recurrent carcinoma. Liver biopsy demonstrated hepatic venoocclusive disease, a rare complication of therapeutic radiation involving the liver. Successful relief of ascites and its adverse symptomology were achieved with the transjugular intrahepatic portosystemic shunt. Relevant literature regarding the pathogenesis, prognosis, and treatment of radiotherapy-related hepatic venoocclusive disease are reviewed.
Shen-Gunther
J
J
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, 73190, USA.
Walker
J L
JL
Johnson
G A
GA
Mannel
R S
RS
D000005:Abdomen; D000230:Adenocarcinoma / Q000532:radiotherapy; D001201:Ascites / Q000209:etiology* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000532:radiotherapy; D005260:Female; D006504:Hepatic Veno-Occlusive Disease / Q000150:complications / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007601:Jugular Veins; D008875:Middle Aged; D010388:Pelvis; D011170:Portasystemic Shunt, Surgical / Q000295:instrumentation; D011878:Radiotherapy / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D015607:Stents