title: Transjugular intrahepatic portosystemic shunt performed in a 2-year-old infant with uncontrollable intestinal bleeding.
abstract: Although transjugular intrahepatic portosystemic shunt (TIPS) is widely accepted in adults, there have been few successful reports in infants. The authors describe a 2-year-old boy with postoperative biliary atresia who underwent TIPS for uncontrollable lower intestinal bleeding and achieved hemostasis. Massive melena developed, which was not controlled by conservative therapy and devascularization. A shunt was created between the right hepatic vein and the right portal vein with a 6- x 50-mm Wallstent. After TIPS, the porto-systemic pressure gradient decreased from 15 to 11 mm Hg, and collaterals markedly reduced. He has not had recurrent bleeding for over 7 months. TIPS may be a technically feasible and effective treatment to control intestinal bleeding in infants. However, further experience and long-term follow-up will be required.
authors.affiliation: Department of Pediatric Surgery, Osaka University Medical School, Suita City, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kimura
authors.forename: T
authors.initials: T
authors.lastname: Hasegawa
authors.forename: T
authors.initials: T
authors.lastname: Oue
authors.forename: T
authors.initials: T
authors.lastname: Hoashi
authors.forename: T
authors.initials: T
authors.lastname: Murakami
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
authors.forename: A
authors.initials: A
authors.lastname: Okada
mesh_terms: D001656:Biliary Atresia / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D002675:Child, Preschool; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D008297:Male; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000379:methods*; D011172:Portography; D012720:Severity of Illness Index; D016896:Treatment Outcome