在与肝的梗塞联系的一个揭开的尖端过程以后的肝失败

• 作者: Daniel Zamora-Valdés Eric López-Méndez Lourdes ávila Mariana Díaz-Zamudio Oscar F Fernández-Díaz
• 来源期刊: 世界肝病学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Hepatic ISCHEMIA ISCHEMIC hepatitis Liver infarc tion Transjugular INTRAHEPATIC portosystemic SHUNT COMPLICATIONS
• 年，卷（期）: 2010,（4）
• 页码范围: 167-170
• 页数: 4页
• 分类号: R575.2

摘要

Transjugular intrahepatic portosystemic shunt (TIPS) is a safe and effective procedure for the treatment of complications of liver cirrhosis, such as refractory ascites, hepatic hydrothorax and refractory variceal bleeding. The aim of this paper is to describe a rare case of liver failure after a TIPS procedure. A 38-year-old diabetic male with Child-Pugh C liver cirrhosis due to chronic hepatitis C infection who had developed refractory ascites was scheduled for a TIPS procedure. Within 24 h following TIPS placement, the patient developed distributive shock, jaundice, persistentgrade 3 hepatic encephalopathy, severe coagulopathy andacute renal failure. He was treated with lactulose enemas, broad-spectrum antibiotics and blood-derived products. Laboratory data revealed a 100-fold increase in aminotransferases and a non-enhanced computed tomography showed an irregular hypodense area in the right posterior segment of the liver. Despite being initially being in a stable condition, the patient developed progressive liver failure and died 2 mo later. Hepatic infarction is an uncommon phenomenon after a TIPS procedure; however, it can greatly complicate the course of a disease in a patient with an already compromised liver function.