[Acute esophagus variceal hemorrhage and portal vein thrombosis as a complication of TIPSS. An unusual emergency indication for liver transplantation].
Acute oesophageal variceal bleeding is a severe complication of portal hypertension caused by liver cirrhosis. The mortality of the first bleeding runs up to 50%. Recurrent bleeding deteriorates the long-term prognosis. The therapy of first choice for acute oesophageal haemorrhage is endoscopic sclerotherapy. A new option to decompress portal hypertension for patients who continue to bleed despite sclerotherapy is TIPSS-implantation. We report on a patient suffering from recurrent oesophageal haemorrhage caused by portal hypertension due to postalcoholic liver cirrhosis, who developed a portal vein thrombosis after TIPSS-implantation. TIPSS-procedure permitted a bridging period for five months, until eventually a severe uncontrollable oesophageal haemorrhage occurred and emergency liver transplantation was needed. The patient was discharged after 6 weeks from the hospital in excellent condition.
Braun
F M
FM
Klinik für Transplantationschirurgie, Georg-August-Universität Göttingen.
Nolte
W
W
Canelo
R
R
Stephan
H
H
Ramadori
G
G
Ringe
B
B
D000328:Adult; D004630:Emergencies; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D011169:Portal Vein / Q000601:surgery*; D011170:Portasystemic Shunt, Surgical / Q000295:instrumentation*; D011183:Postoperative Complications / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D015607:Stents; D013927:Thrombosis / Q000601:surgery*