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Radiology, Vol 191, 183-187, Copyright © 1994 by Radiological Society of North America

ARTICLES

Intestinal varices: treatment with the transjugular intrahepatic portosystemic shunt

ZJ Haskal, M Scott, RA Rubin and C Cope
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.

PURPOSE: To perform a retrospective evaluation of transjugular intrahepatic portosystemic shunt (TIPS) placement for treatment of intestinal varices. MATERIALS AND METHODS: TIPS were placed in nine patients (six women and three men, aged 36-85 years [mean, 64 years]) with small- (n = 6) and large- (n = 3) intestinal varices. Six patients were actively bleeding at the time of shunt placement. One patient with colon cancer underwent prophylactic TIPS placement for variceal decompression before colectomy. RESULTS: The mean preprocedure portosystemic gradient of 26.8 mm Hg +/- 5.1 was reduced to 8.8 mm Hg +/- 2.9. Bleeding was controlled in all but one case, in which supplemental variceal embolization was required. Two patients died within 5 days of TIPS placement of preexisting multisystem failure. Three patients died of unrelated causes at 2, 6, and 7 months. The remaining patients were alive an average of 15 months after TIPS placement. There was no recurrent bleeding in any case. CONCLUSION: TIPS placement is an effective method of decompressing intestinal varices.




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