[Treatment of refractory ascites using a transjugular intrahepatic portosystemic shunt (TIPS). Clinical case].
Approximately, 10% of cirrhotic patients with ascites become refractory to medical treatment, a condition that reduces overall survival. TIPS is a therapeutic alternative for the management of refractory ascites. It corrects sinusoidal portal hypertension, becoming a rational and relatively safe therapeutic approach. The most frequent complications of TIPS are the development of hepatic encephalopathy and a high incidence of shunt stenosis or occlusion after one year of follow-up. We report a 43 years old alcoholic cirrhotic male with ascites refractory to medical treatment, that required multiple large volume paracentesis, whose clinical condition deteriorated progressively. A TIPS was successfully placed with a rapid and complete resolution of ascites and marked improvement of his clinical condition. During the ensuing six months the patient remained in excellent conditions, but was lost from follow-up and resumed excessive alcohol intake. Eight months after TIPS placement he had an upper gastrointestinal bleeding and died.
Zapata
R
R
Hospital del Salvador, Departamento de Medicina Oriente, Facultad de Medicina, Universidad de Chile, Santiago 9, Chile. rzapata@machi.med.uchile.cl
Fava
M
M
D000328:Adult; D001201:Ascites / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D016896:Treatment Outcome