title: Cerebral edema and hyperammonemia after transjugular intrahepatic portosystemic shunt placement in a cirrhotic patient.
abstract: Transjugular intrahepatic portosystemic shunt (TIPS) placement has been widely performed for nearly two decades and has been shown to alleviate refractory ascites in patients with cirrhosis. Hepatic encephalopathy after TIPS is rarely severe; however, a risk of cerebral edema resulting from hyperammonemia after TIPS does exist. Here we describe a case demonstrating the development of severe hepatic encephalopathy with cerebral edema caused by hyperammonemia as a complication of TIPS in a patient with chronic liver disease with relatively preserved liver function.
authors.affiliation: Department of Medicine, Section of Gastroenterology, University of Chicago, Chicago, Illinois 60637, USA.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Kavitt
authors.forename: Vincent L
authors.initials: VL
authors.lastname: Yang
authors.forename: Donald M
authors.initials: DM
authors.lastname: Jensen
mesh_terms: D001929:Brain Edema / Q000209:etiology*; D006801:Humans; D022124:Hyperammonemia / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects*