Using TIPS procedure with covered stent in a patient with Budd-Chiari

Abstract

Based on a case report of a young female patient admitted
with two uncommon diseases, Budd-Chiari syndrome and
polycythaemia vera, the authors intend to make a brief review of
these pathologies and particularly TIPS (Transjugular Intrahepatic
Portosystemic Shunt) therapeutic approach with covered stent.
Budd-Chiari syndrome is a rare disorder characterized by the
obstruction of the hepatic venous outflow, in most cases associated with thrombotic events, mainly myeloproliferative disorders.
This obstruction causes venous congestion leading to hepatocelular necrosis and atrophy with subsequent portal hypertension
and cirrhosis. Clinically a triad of abdominal pain, ascites and liver
enlargement, which is very unspecific, was described.
The therapeutic options are made of medical procedures and
invasive relief of such obstruction. Isolated procedures are only
recommended if there is no liver necrosis.
TIPS has proven to be an effective portosystemic derivative
approach with lower mortality than surgical shunts.