| Journal: | Annals of hepatology |
| Database: | PERIÓDICA |
| System number: | 000413431 |
| ISSN: | 1665-2681 |
| Authors: | Pedersen, Mark R1 Molloy, Peter1 Wood, David1 Seetharam, Anil1 |
| Institutions: | 1Banner University Medical Center, Transplant Center and Advanced Liver Diseases, Phoenix, Arizona. Estados Unidos de América |
| Year: | 2016 |
| Season: | Ene-Feb |
| Volumen: | 15 |
| Number: | 1 |
| Pages: | 127-130 |
| Country: | México |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Caso clínico |
| English abstract | Budd-Chiari syndrome (BCS) refers to hepatic venous outflow obstruction that in severe cases can lead to acute liver failure prompting consideration of revascularization or transplantation. Here, a 22 year old female with angiographically proven BCS secondary to JAK2/V617F positive Polycythemia vera on therapeutic warfarin presented with acute liver failure (ALF). Imaging revealed a new, near complete thrombotic occlusion of the main portal vein with extension into the superior mesenteric vein. An emergent direct intrahepatic portocaval shunt (DIPS) was created and liver function promptly normalized. She has been maintained on rivaroxaban since that time. Serial assessment over 1 year demonstrated continued shunt patency and improved flow in the mesenteric vasculature on ultrasound as well as normal liver function. DIPS is a viable alternative in the treatment of ALF from BCS when standard recanalization is not feasible. Improved blood flow may also improve portal/mesenteric clot burden. While further investigation is needed, new targeted anticoagulants may be viable as a long term anticoagulation strategy |
| Disciplines: | Medicina |
| Keyword: | Cirugía, Gastroenterología, Sistema cardiovascular, Trombosis venosa, Vena cava, Trombosis portal, Falla hepática aguda, Síndrome de Budd-Chiari, Derivación directa intrahepática portocaval |
| Keyword: | Medicine, Cardiovascular system, Gastroenterology, Surgery, Venous thrombosis, Cava vein, Portal thrombosis, Acute liver failure, Budd-Chiari syndrome, Direct intrahepatic portocaval shunt |
| Full text: | Texto completo (Ver PDF) |
