We report a case of fulminant hepatic failure in a 55-yr-old man due to Budd-Chiari syndrome in the setting of polycythemia rubra vera. The patient presented with acute hepatic failure, which rapidly progressed to grade IV hepatic encephalopathy. Placement of a transjugular intrahepatic portosystemic shunt resulted in marked improvement of the encephalopathy and stabilized the liver failure. Subsequently, he underwent successful nonemergent orthotopic liver transplantation. Transjugular intrahepatic portosystemic shunt placement is a safe, effective, therapeutic option to bridge patients with fulminant Budd-Chiari to liver transplantation.
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Gastro Hep Adv
September 2024
Blacktown Clinical School, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia.
World J Gastroenterol
January 2025
Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou 510151, Guangdong Province, China.
Background: Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for managing complications of portal hypertension, particularly acute variceal bleeding (AVB). While effective in reducing portal pressure and preventing rebleeding, TIPS is associated with a considerable risk of overt hepatic encephalopathy (OHE), a complication that significantly elevates mortality rates.
Aim: To develop a machine learning (ML) model to predict OHE occurrence post-TIPS in patients with AVB using a 5-year dataset.
J Biomech
January 2025
School of Mechanical Engineering, Hefei University of Technology, Hefei, Anhui 230009, PR China. Electronic address:
Hemodynamic processes from the portal vein(PV) to the inferior vena cava(IVC) were mimicked for three patients with portal hypertension(PH) and the effects of stent parameters on the outcomes of transjugular intrahepatic portosystemic shunt(TIPS) were investigated through computational fluid dynamics(CFD). The liver region was simulated with porous media model and the spatial distributions of superior mesenteric vein(SMV) and splenic vein(SV) blood were solved through the Eulerian multiphase model. The present method is able to simulate the PH flow and predict the PV pressure, the stent shunt rate and the SMV blood proportion after TIPS treatment.
View Article and Find Full Text PDFWorld J Gastrointest Surg
January 2025
Department of Surgery, Gastroenterology and Digestive Endoscopy Unit, ASST Santi Paolo e Carlo, University of Milan, Milan 20142, Lombardy, Italy.
Trans-jugular intrahepatic portosystemic stent shunting (TIPSS) has been in use for many years with great results and many evolutions. The procedure essentially involves the insertion of a metal covert stent to create an Hepato-Hepatic portosystemic shunt. Over time, TIPSS has become the subject of many studies aimed at examining its clinical utility and evaluating the results of using TIPSS to manage complications related to portal hypertension.
View Article and Find Full Text PDFWorld J Hepatol
January 2025
Department of Gastroenterology, Huizhou Central People's Hospital, Huizhou 516000, Guangdong Province, China.
Background: Chylous ascites is an uncommon condition, occurring in less than 1% of ascites cases. It results from traumatic or obstructive disruption of the lymphatic system, causing the leakage of thoracic or intestinal lymph into the abdominal cavity. This leads to the accumulation of a milky, triglyceride-rich fluid.
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