Transjugular intrahepatic portosystemic shunt performed in a 2-year-old infant with uncontrollable intestinal bleeding.
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.
Kimura
T
T
Department of Pediatric Surgery, Osaka University Medical School, Suita City, Japan.
Hasegawa
T
T
Oue
T
T
Hoashi
T
T
Murakami
T
T
Nakamura
K
K
Okada
A
A
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