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Canadian Journal of Gastroenterology
Volume 8, Issue 2, Pages 75-80
http://dx.doi.org/10.1155/1994/670464
Clinical Hepatology

Successful Reversal of Chronic Incapacitating Post-TIPS Encephalopathy by Balloon Occlusion of the Stent

Daphna Fenyves, Michel P Dufresne, Jean Raymond, Michel Lafortune, Bernard Willems, and Gilles Pomier-Layrargues

Liver Unit and Department of Radiology, Hôpital Saint-Luc and Université de Montréal, Montreal, Quebec, Canada

Received 3 September 1993; Accepted 15 December 1993

Copyright © 1994 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) placement is a new technique allowing decompression of the portal system without the need for abdominal surgery or general anesthetic. This promising procedure appears safe, and is being evaluated in the context of life threatening uncontrollable variceal hemorrhage as well as ascites refractory to medical treatment. Following TIPS, portal flow diversion is associated with hepatic encephalopathy in up to 25% of patients. This is most often mild and treatable but may become uncontrollable, incapacitating and even life threatening in up to 3 to 5% of cases. The authors present two patients in whom such life threatening encephalopathy and stupor was reversed by transjugular balloon occlusion of the TIPS.