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CardioVascular and Interventional Radiology

, Volume 24, Issue 1, pp 64–67 | Cite as

Infarction and laceration of liver parenchyma caused by wedged CO2 venography before TIPS insertion

  • Ingo Theuerkauf
  • Holger Strunk
  • Karl August Brensing
  • Hans Heinz Schild
  • Ulrich Pfeifer
Case Reports

Abstract

We describe the fatal outcome of an elective TIPS procedure performed in a 43-year-old man with alcoholic cirrhosis. Wedged hepatic venography with CO2 was the reason for infarction and laceration of liver parenchyma resulting in a subcapsular hematoma and subsequent intra-abdominal bleeding. This is the first report of this complication after the use of CO2 in a cirrhotic patient.

Key words

Wedged venography, complications TIPS, complications Liver, injuries Shunts, portosystemic 

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References

  1. 1.
    Richter GM, Noeldge G, Palmaz JC, Roessle M, Slegerstetter V, Franke M, Gerok W, Wenz W, Farthmann E (1990) Transjugular intrahepatic portocaval stent shunt: Preliminary clinical results. Radiology 174: 1027–1030PubMedGoogle Scholar
  2. 2.
    Zemel G, Katzen BT, Becker GJ, Benenati JF, Sallee DS (1991) Percutaneous transjugular portosystemic shunt. JAMA 266:390–393PubMedCrossRefGoogle Scholar
  3. 3.
    LaBerge JM, Ring EJ, Gordon RL, Lake JR, Doherty MM, Somberg KA, Roberts JP, Ascher NL (1993) Creation of transjugular intrahepatic portosystemic shunts with the Wallstent endoprothesis: Results in 100 patients. Radiology 187:413–420PubMedGoogle Scholar
  4. 4.
    Freedman AM, Sanyal AJ, Tisnado J, Cole PE, Shiffmann ML, Luketic VA, Purdum PP, Darcy MD, Posner MP (1993) Complications of transjugular intrahepatic portosystemic shunt: A comprehensive review. Radiographics 13:1185–1210PubMedGoogle Scholar
  5. 5.
    Haskal ZJ, Pentecost MJ, Rubin RA (1993) Hepatic arterial injury after transjugular intrahepatic portosystemic shunt placement: Report of two cases. Radiology 188:85–88PubMedGoogle Scholar
  6. 6.
    Semba CP, Saperstein L, Nymann U, Dake MD (1996) Hepatic laceration from wedged venography performed before transjugular intrahepatic portosystemic shunt placement. J Vase Interv Radiol 7:143–146CrossRefGoogle Scholar
  7. 7.
    Kantermann RY (1996) Hepatic laceration from wedged venography before transjugular intrahepatic portosystemic shunt placement: One survivor. J Vase Interv Radiol 7:776–777CrossRefGoogle Scholar
  8. 8.
    Rees CR, Niblett RL, Lee SP, Diamond NG, Crippin JS (1994) Use of carbon dioxide as a contrast medium for transjugular intrahepatic portosystemic shunt procedures. J Vase Interv Radiol 5:383–386CrossRefGoogle Scholar
  9. 9.
    Brensing KA, Textor J, Strunk H, Klehr HU, Schild H, Sauerbruch T (1997) Transjugular intrahepatic portosystemic stent-shunt for hepatorenal syndrome. Lancet 349:697–698PubMedCrossRefGoogle Scholar
  10. 10.
    Guevara M, Gtnes P, Fernandez-Esparrach G, Sort P, Salmerón JM, Jimenez W, Arroyo V, Rodes J (1998) Reversibility of hepatorenal syndrome by prolonged administration of ornipressin and plasma volume expansion. Hepatology 27:35–41PubMedCrossRefGoogle Scholar
  11. 11.
    Kadir S (1986) Diagnostic Angiography. WB Saunders, Philadelphia, pp 390–392Google Scholar
  12. 12.
    Castañeda-Zúñiga WR, Jauregui H, Rysavy JA, Formanek A, Amplatz K (1978) Complications of wedge hepatic venography. Radiology 126:53–56PubMedGoogle Scholar
  13. 13.
    Taylor FC, Smith DC, Watkins GE, Könne RE, Suh RD (1999) Balloon occlusion versus wedged hepatic venography using carbon dioxide for portal vein opacification during TIPS. Cardiovasc Intervent Radiol 22:150–151PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York, Inc 2001

Authors and Affiliations

  • Ingo Theuerkauf
    • 1
  • Holger Strunk
    • 2
  • Karl August Brensing
    • 3
  • Hans Heinz Schild
    • 2
  • Ulrich Pfeifer
    • 1
  1. 1.Department of PathologyUniversity of BonnBonnGermany
  2. 2.Department of RadiologyUniversity of BonnBonnGermany
  3. 3.Department of internal MedicineUniversity of BonnBonnGermany

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