Abstract

ZAPATA L, Rodrigo  and  FAVA P, Mario. Treatment of refractory ascites using a transjugular intrahepatic portosystemic shunt (TIPS).: Report of one case. Rev. méd. Chile [online]. 1999, vol.127, n.10, pp. 1229-1235. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98871999001000011.

Approximately, 10% of cirrhotic patients with ascites become refractory to medical treatment, a condition that reduces overall survival. TIPS is a therapeutic alternative for the management of refractory ascites. It corrects sinusoidal portal hypertension, becoming a rational and relatively safe therapeutic approach. The most frequent complications of TIPS are the development of hepatic encephalopathy and a high incidence of shunt stenosis or occlusion after one year of follow-up. We report a 43 years old alcoholic cirrhotic male with ascites refractory to medical treatment, that required multiple large volume paracentesis, whose clinical condition deteriorated progressively. A TIPS was successfully placed with a rapid and complete resolution of ascites and marked improvement of his clinical condition. During the ensuing six months the patient remained in excellent conditions, but was lost from follow-up and resumed excessive alcohol intake. Eight months after TIPS placement he had an upper gastrointestinal bleeding and died.

Keywords : Ascitic Fluid; Hepatic Encephalopathy; Liver Cirrhosis; Liver Circulation; Portacanal Shunt; Portal System.