Intra-hepatic haematoma complicating transjugular intra-hepatic portosystemic shunt for Budd-Chiari syndrome associated with anti-phospholipid antibodies, aplastic anaemia and chronic hepatitis C.
Portal venous decompression with transjugular intra-hepatic portosystemic shunt (TIPS) is a new approach in the treatment of Budd-Chiari syndrome. We report on a 31-year-old female with Budd-Chiari syndrome due to anti-phospholipid antibodies with compression of the inferior vena cava treated with TIPS and stenting of the inferior vena cava. TIPS was complicated by massive intra-hepatic haematoma which was managed conservatively. Treatment options and pathogenic mechanisms of Budd-Chiari syndrome under the rare coincidence of aplastic anaemia and anti-phospholipid syndrome are discussed. TIPS may be considered for venous decompression in Budd-Chiari syndrome, but physicians should be aware of potential TIPS' complications in these patients.
Department of Medicine, Karl Franzens University, Graz, Austria.
P
P
Fickert
M
M
Trauner
K
K
Hausegger
J
J
Tauss
H
H
Lackner
G J
GJ
Krejs
R E
RE
Stauber
D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications / Q000175:diagnosis; D000792:Angiography; D017152:Antibodies, Antiphospholipid / Q000097:blood; D000925:Anticoagulants / Q000008:administration & dosage; D006502:Budd-Chiari Syndrome / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D008111:Liver Function Tests; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography
D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants