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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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
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author Kawahara, Yo
Tanaka, Yoshihiro
Isoi, Naoaki
Hatanaka, Kohsuke
Yamada, Kentaro
Yamamoto, Masayoshi
Okamura, Teppei
Kaji, Tatsumi
Sakamoto, Toshihisa
Saitoh, Daizoh
Ikeuchi, Hisashi
author_facet Kawahara, Yo
Tanaka, Yoshihiro
Isoi, Naoaki
Hatanaka, Kohsuke
Yamada, Kentaro
Yamamoto, Masayoshi
Okamura, Teppei
Kaji, Tatsumi
Sakamoto, Toshihisa
Saitoh, Daizoh
Ikeuchi, Hisashi
author_sort Kawahara, Yo
collection PubMed
description 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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spelling pubmed-56744662017-11-09 Direct intrahepatic portocaval shunt for refractory hepatic hydrothorax: a case report Kawahara, Yo Tanaka, Yoshihiro Isoi, Naoaki Hatanaka, Kohsuke Yamada, Kentaro Yamamoto, Masayoshi Okamura, Teppei Kaji, Tatsumi Sakamoto, Toshihisa Saitoh, Daizoh Ikeuchi, Hisashi Acute Med Surg Case Reports 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. John Wiley and Sons Inc. 2016-12-09 /pmc/articles/PMC5674466/ /pubmed/29123879 http://dx.doi.org/10.1002/ams2.257 Text en © 2016 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Case Reports
Kawahara, Yo
Tanaka, Yoshihiro
Isoi, Naoaki
Hatanaka, Kohsuke
Yamada, Kentaro
Yamamoto, Masayoshi
Okamura, Teppei
Kaji, Tatsumi
Sakamoto, Toshihisa
Saitoh, Daizoh
Ikeuchi, Hisashi
Direct intrahepatic portocaval shunt for refractory hepatic hydrothorax: a case report
title Direct intrahepatic portocaval shunt for refractory hepatic hydrothorax: a case report
title_full Direct intrahepatic portocaval shunt for refractory hepatic hydrothorax: a case report
title_fullStr Direct intrahepatic portocaval shunt for refractory hepatic hydrothorax: a case report
title_full_unstemmed Direct intrahepatic portocaval shunt for refractory hepatic hydrothorax: a case report
title_short Direct intrahepatic portocaval shunt for refractory hepatic hydrothorax: a case report
title_sort direct intrahepatic portocaval shunt for refractory hepatic hydrothorax: a case report
topic Case Reports
url 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
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