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Title: Percutaneous transhepatic approach to portosystemic shunt procedure for acute variceal haemorrhage
e-poster Number: EPOS 30
Category: e Poster
Author Name: Dr. Satvik Dhirawani
Institute:
Co-Author Name:
Abstract :
ABSTRACT TITLE:
Percutaneous transhepatic approach to portosystemic shunt procedure for acute variceal haemorrhage
Author Name: Dr Satvik Dhirawani
Designation – DM Resident (1st Year)
Co Author: Dr Pankaj Banode (HOD- Interventional Radiology)
Insititute: Jawaharlal Nehru Medical College, Sawangi, Wardha
Mobile: 9302042326
Email:satvikdhirawani94@gmail.com
ABSTRACT
Decompression of the portal vein via creation of a shunt to the hepatic venous system is an important therapeutic minimally invasive intervention for patients with decompensated liver cirrhosis suffering from portal hypertension with refractory ascites and/or uncontrollable upper GI-bleeding.
Here we are presenting the case of a 55 year old male patient who presented to us with hematemesis, melena and significant drop in Haemoglobin. Radiological investigations and lab parameters were studied and clinically the patient was assessed and was identified as a suitable candidate for TIPSS procedure. Under normal circumstances and suitable anatomic conditions the decompression is achieved by creation of TIPS. However, in our case there was significant stenosis of bilateral internal jugular veins and the alternatives were limited. Thus we had opted for direct percutaneous approach using transhepatic portal vein puncture with a chibba needle and then extending the puncture under USG guidance into the hepatic vein and the thus the access was gained by snaring the guidewire from the left femoral vein. This case is unique in the way how there were limited options to perform the TIPSS procedure due to difficult anatomical circumstances and how this problem was addressed and navigated using a percutaneous transhepatic approach.
