Pancreaticoportal Fistula and Disseminated Fat Necrosis After Revision of a Transjugular Intrahepatic Portosystemic Shunt

Journal Article · Mon Apr 15 00:00:00 EDT 2013 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-012-0380-6· OSTI ID:22156393

Saad, Nael ^[1]; Korenblat, Kevin ^[2]; Darcy, Michael D. ^[1]

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1. Washington University School of Medicine, Interventional Radiology Section, Mallinckrodt Institute of Radiology (United States)
2. Washington University School of Medicine, Division of Gastroenterology, Department of Internal Medicine (United States)

A 59-year old man with alcohol related cirrhosis and portal hypertension was referred for transjugular intrahepatic portosystemic shunt (TIPS) to treat his refractory ascites. Ten years later, two sequential TIPS revisions were performed for shunt stenosis and recurrent ascites. After these revisions, he returned with increased serum pancreatic enzyme levels and disseminated superficial fat necrosis; an iatrogenic pancreaticoportal vein fistula caused by disruption of the pancreatic duct was suspected. The bare area of the TIPS was subsequently lined with a covered stent-graft, and serum enzyme levels returned to baseline. In the interval follow-up period, the patient has clinically improved.

• OSTI ID: 22156393
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 36, Issue 2; Other Information: Copyright (c) 2013 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ASCITES
ENZYMES
GRAFTS
HYPERTENSION
MAN
NECROSIS
PANCREAS
PATIENTS
VEINS