Malpositioned transjugular intrahepatic portosystemic shunt in the common hepatic duct leading to biliary obstruction and liver transplantation

✍ Scribed by Flavio Paterno; Adeel Khan; Keith Cavaness; Massimo Asolati; Jeffrey Campsen; Greg J. McKenna; Nicholas Onaca; Richard Ruiz; James Trotter; Goran B. Klintmalm

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 169 KB
• Volume: 17
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.22255

✦ Synopsis

For more than 20 years, placement of a transjugular intrahepatic portosystemic shunt (TIPS) has been a first-line treatment option for portal hypertension in patients with decompensated cirrhosis. It has been used in the management of complications such as variceal bleeding and refractory ascites. [1][2][3] The most commonly reported complications of TIPS include hepatic encephalopathy (10%-49%), shunt stenosis or occlusion (13%-15% with covered stents and 18%-78% with bare stents), sepsis (2%-10%), and stent migration to the portal vein or the right atrium (8%-20%). 1,4 Biliary complications from TIPS are considered rare, and only a few cases have been described. [5][6][7][8][9][10][11][12] We report an unusual complication: the misplacement of a TIPS into the common hepatic duct (CHD).