Cerebral Edema and Hyperammonemia After Transjugular Intrahepatic Portosystemic Shunt Placement in a Cirrhotic Patient

Transjugular intrahepatic portosystemic shunt (TIPS) placement has been widely performed for nearly two decades and has been shown to alleviate refractory ascites in patients with cirrhosis. Hepatic encephalopathy after TIPS is rarely severe; however, a risk of cerebral edema resulting from hyperamm...

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Published inClinical gastroenterology and hepatology Vol. 6; no. 9; pp. 1054 - 1056
Main Authors Kavitt, Robert T, Yang, Vincent L, Jensen, Donald M
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.09.2008
Subjects
Brain Edema - etiology
Gastroenterology and Hepatology
Humans
Hyperammonemia - etiology
Liver Cirrhosis - complications
Liver Cirrhosis - surgery
Male
Middle Aged
Portasystemic Shunt, Surgical - adverse effects
computed tomography
continuous venovenous hemodialysis
CT
Model for End-Stage Liver Disease
MELD
transjugular intrahepatic portosystemic shunt
United Network for Organ Sharing
CVVH
UNOS
TIPS
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Summary:Transjugular intrahepatic portosystemic shunt (TIPS) placement has been widely performed for nearly two decades and has been shown to alleviate refractory ascites in patients with cirrhosis. Hepatic encephalopathy after TIPS is rarely severe; however, a risk of cerebral edema resulting from hyperammonemia after TIPS does exist. Here we describe a case demonstrating the development of severe hepatic encephalopathy with cerebral edema caused by hyperammonemia as a complication of TIPS in a patient with chronic liver disease with relatively preserved liver function.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ISSN:1542-3565
1542-7714
DOI:10.1016/j.cgh.2008.04.020