Transjugular intrahepatic portosystemic shunt (TIPSS)

Case contributed by Paresh K Desai
Diagnosis almost certain


Case of Budd Chiari syndrome. On anticoagulation. Refractory ascites and variceal bleeding.

Patient Data

Age: 30 years
Gender: Female

A TIPSS shunt is created; portal venous injection after the TIPSS creation shows the preferential flow from the main portal vein through the shunt into a main hepatic vein near its confluence with the inferior vena cava.

Case Discussion

Patient is a case of Budd Chiari syndrome with hepatic venous stenting done in the past.

The hepatic venous stent had restenosed and there was refractory ascites and intermittent variceal bleeding.

Hence a TIPSS shunt was created. 

Injection into the portal vein after TIPSS creation shows a good preferential flow toward the IVC.

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