Direct intrahepatic portocaval shunt for refractory hepatic hydrothorax: a case report

CASE: A 64‐year‐old man with complaints of dyspnea and orthopnea secondary to a hepatic hydrothorax refractory to diuretic medication underwent the transjugular intrahepatic portosystemic shunt (TIPS) procedure to decrease the portal vein pressure. The TIPS procedure failed due to severe liver stiff...

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Detalles Bibliográficos
Autores principales: Kawahara, Yo, Tanaka, Yoshihiro, Isoi, Naoaki, Hatanaka, Kohsuke, Yamada, Kentaro, Yamamoto, Masayoshi, Okamura, Teppei, Kaji, Tatsumi, Sakamoto, Toshihisa, Saitoh, Daizoh, Ikeuchi, Hisashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Case Reports
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674466/
https://www.ncbi.nlm.nih.gov/pubmed/29123879
http://dx.doi.org/10.1002/ams2.257
Descripción
Sumario:CASE: A 64‐year‐old man with complaints of dyspnea and orthopnea secondary to a hepatic hydrothorax refractory to diuretic medication underwent the transjugular intrahepatic portosystemic shunt (TIPS) procedure to decrease the portal vein pressure. The TIPS procedure failed due to severe liver stiffness. Direct intrahepatic portocaval shunt (DIPS), a modified TIPS procedure that directly inserts a stent from the inferior vena cava to the portal vein, was successfully carried out. OUTCOME: The DIPS procedure significantly decreased the patient's pleural effusion and respiratory symptoms. CONCLUSION: No other medical treatment is available to control refractory pleural effusion caused by portal hypertension; however, the TIPS (or DIPS) procedure can be successfully carried out in patients <60 years old with a Model of End‐Stage Liver Disease score <15.

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