Acute liver failure and infarction complicating TIPS placement

• Main Authors: Guo-Ping Liu, MD, Mei-Ying Zhang, MD, Rui Xu, PhD, Cheng-Jian Sun, MD
• Format: Article
• Language: English
• Published: Elsevier 2019-07-01
• Series: Radiology Case Reports
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043319301116

Here in we report a case of acute liver failure with hepatic infarction after transjugular intrahepatic portosystemic shunt (TIPS). An upper gastrointestinal hemorrhage patient with a medical history of alcoholic cirrhosis underwent a TIPS procedure. One day after TIPS, his alanine aminotransferase and aspartate aminotransferase levels increased to 1214 U/L and 1511 U/L, respectively. Two days after TIPS, they peaked at alanine aminotransferase 8389 U/L and aspartate aminotransferase >7500 U/L, respectively. An emergent stent occlusion was performed on the second day. Portography showed that there were no portal vein branches or parenchymal stains on the edge of the right liver lobe. A CT scan demonstrated diffuse hepatic parenchyma, homogeneous hypodense lesion, and bilateral pleural effusion. The patient died of liver failure and multiple organ dysfunction syndrome 6 hours after the stent occlusion. Keywords: Transjugular intrahepatic portosystemic shunt, Hepatic infarction, liver failure