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Budd-Chiari syndrome with portal, splenic, and superior mesenteric vein thrombosis treated with TIPS: who dares wins
  1. A Mancuso1,
  2. A Watkinson2,
  3. J Tibballs2,
  4. D Patch3,
  5. A K Burroughs3
  1. 1Universita’ di Palermo, Scuola di Specializzazione in Gastroenterologia ed Endoscopia Digestiva, Reparto di Medicina, Ospedale V Cervello, Via Trabucco 180, 90144, Palermo, Italy
  2. 2Department of Radiology, Royal Free Hospital, London, UK
  3. 3Liver Transplantation Unit and Hepatobiliary Medicine, Royal Free Hospital, London, UK; andrew.burroughs@talk21.com
  1. Correspondence to:
    A K Burroughs, Liver Transplantation Unit and Hepatobiliary Medicine, Royal Free Hospital, Pond St, Hampstead NW3 2QG, London, UK;
    andrew.burroughs{at}talk21.com

https://doi.org/10.1136/gut.52.3.438

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    PATIENT/HISTORY

    A 20 year old man presented with severe ascites and malnutrition due to Budd-Chiari syndrome (BCS) with portal vein (PV), and splenic and mesenteric vein (SMV) thrombosis in the proximal 3 cm. He had received regular and more frequent paracenteses of up to 17 litres each for eight months. He had a poor BCS prognostic index of 8.41 (table 1). After referral, despite full anticoagulation and diuretic drugs, he deteriorated over three weeks. No thrombophilic disorder was found.

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    Table 1

    Comparison of laboratory and clinical data before and two months after transjugular intrahepatic portosystemic stent shunt (TIPS)

    DIAGNOSTIC PROCEDURES/INTERVENTION

    He underwent transjugular intrahepatic portosystemic stent shunt (TIPS) under …

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