Abstract YO12
Case summary
The management of shunt dysfunction caused by stent deviation during transjugular intrahepatic portosystemic shunt surgery for esophageal and gastric varices bleeding：a case report and comprehensive literature review
Purpose:The transjugular intrahepatic portosystemic shunt (TIPS) has emerged as a pivotal treatment modality for cirrhotic portal hypertension; however, the occurrence of stent restenosis following TIPS remains a significant obstacle to achieving optimal mid- and long-term therapeutic outcomes.The purpose of this clinical case report is to highlight this unusual outflow tract stenosis and help us make the correct diagnosis and management
Method:The research subject chosen for our study is a patient who was admitted to the hospital in February 2024 with outflow tract stenosis after undergoing a TIPS procedure. We conducted a comparative analysis by observing his preoperative, intraoperative, and postoperative imaging data as well as laboratory tests.
Result:The patient was admitted to the hospital with complaints of hematemesis and black stools that had occurred 10 days prior. The patient received a diagnosis of early-stage liver cirrhosis with bleeding esophageal and gastric varices, decompensated stage of post-hepatitis cirrhosis, portal hypertension. These findings were consistent with the indications for TIPS surgery. Shunt stenosis occurred after the initial TIPS procedure, initially suspected to be due to stent thrombosis. However, during the second operation it was discovered that there was no thrombosis in the stent; instead, shunt stenosis resulted from migration of the stent along its course. To address this issue, an additional bare stent was overlaid on top of the original one to provide enhanced support.
Conclusion:Ensuring prompt identification and management of stent restenosis following the TIPS procedure is crucial for maintaining uninterrupted shunt patency and preventing the recurrence of portal hypertension.