Hepatic encephalopathy as an unusual late complication of transjugular intrahepatic portosystemic shunt insertion for non-cirrhotic portal hypertension caused by nodular regenerative hyperplasia in an HIV-positive patient on highly active antiretroviral therapy.
Transjugular intrahepatic portosystemic shunt (TIPS) is an artificially created conduit between the portal and systemic vascular system in the liver performed percutaneously via radiological guidance. It is used mainly in conditions causing portal hypertension and its resulting complications. It reduces portal pressure by diverting portal blood flow into the systemic circulation. Hepatic encephalopathy is the most common complication following TIPS insertion and tends to present fairly early. We describe a case of hepatic encephalopathy as an unusual late complication of TIPS insertion (first presenting six years after) for non-cirrhotic portal hypertension caused by nodular regenerative hyperplasia in an HIV-positive patient on highly active antiretroviral therapy.
Ding
A
A
Liver Unit, Royal Victoria Hospital, Belfast, UK. alcding@rocketmail.com
Lee
A
A
Callender
M
M
Loughrey
M
M
Quah
S P
SP
Dinsmore
W W
WW
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D020518:Focal Nodular Hyperplasia / Q000150:complications; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy; D006501:Hepatic Encephalopathy / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery*; D008099:Liver / Q000601:surgery; D008297:Male; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*
D019380:Anti-HIV Agents