Application of Color Doppler ultrasound in monitoring the effect of reducing the transjugular portosystem shunt due to hepatic encephalopathy: Case report
Abstract
Transjugular portosystemic shunt (TIPS) is interventional vascular radiology procedure, which represents a method of choice for reducing problems of patients with portent hypertension. However, in a number of patients as a late complication hepatic encephalopathy (HE) may occur, thus in that situation the reduction of lumen trough shunt’s flow is needed. In such patient cases, with Color Doppler ultrasound (CDU), we can determine the flow through shunt, before and after reduction of lumen. In this article is presented the case of patient, where after of using of TIPS, the hepatic encephalopathy occurred and after the reduction of lumen has been conducted. The effects of procedure are followed by Color Doppler ultrasound. Conclusion: CDU as simple and non-invasive, with high rate of specifics and sensitivity, represent adequate radiology method, which can be used for monitoring conditions of patient with TIPS, more precise for monitoring the effects of reduction of shunt’s lumen.
References
Qin JP, Jiang MD, Tang W, et al. Clinical effects and complications of TIPS for portal hypertension due to cirrhosis: a single center. World J Gastroenterol. 2013;19(44):8085-92.
Casadaban LC, Parvinian A, Minocha J, et al. Clearing the Confusion over Hepatic Encephalopathy After TIPS Creation: Incidence, Prognostic Factors, and Clinical Outcomes. Dig Dis Sci. 2015;60(4):1059-66.
Rössle M, Gerbes AL. TIPS for the treatment of refractory ascites, hepatorenal syndrome and hepatic hydrothorax: a critical update. Gut. 2010;59(7):988-1000.
Colombato L. The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension. J Clin Gastroenterol. 2007;41 Suppl 3:S344-51.
Krishnamoorthy TL, Taneja M, Chang PE. Symptomatic hepatic hydrothorax successfully treated with transjugular intrahepatic portosystemic shunt (TIPS)-role of titration of portosystemic gradient reduction to avoid post-TIPS encephalopathy. Clin Case Rep. 2014;2(3):93-7.
Brkljačić B. Dopler krvnih žila. Zagreb: Medicinska naklada Zagreb; 2000.
Sajja KC, Dolmatch BL, Rockey DC. Long-term follow-up of TIPS created with expanded poly-tetrafluoroethylene covered stents. Dig Dis Sci. 2013;58(7):2100-6.
Puttemans T, Van beers BE, Goffette P, Dardenne AN, Pringot J. [Follow-up of TIPS: evaluation of signs of dysfunction with Doppler ultrasonography]. J Radiol. 1996;77(12):1201-6.