Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Refractory Transudative Chylothorax due to Liver Cirrhosis

Khaliq, Muhammad Farhan; Noorani, Muhammad Muslim; Chowdhry, Monica; Mohamed, Hesham; Koirala, Ashish

doi:10.1155/2020/2581040

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…It aims to create adhesions between the parietal and visceral pleura to prevent the accumulation of fluid in the space [ 10 ]. Transjugular intrahepatic portosystemic shunt (TIPS) has been previously used in cirrhotic patients with recurrent chylothorax and chylous ascites [ 11 - 12 ]. Portal decompression with a TIPS is thought to reduce lymphatic flow and provide treatment for recurrent chylous effusions.…”

Section: Discussionmentioning

confidence: 99%

Left-Sided Transudative Chylothorax With Concomitant Chylous Ascites in the Setting of Liver Cirrhosis

Gukasyan¹,

Phan²,

Hu³

et al. 2023

Cureus

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Most chylothoraces are caused by trauma and malignancy, and pleural fluid analysis typically demonstrates an exudative effusion. Transudative chylothorax is a rare manifestation and has only been cited in case reports in the current literature. Here, we present the case of a 59-year-old male with a history of liver cirrhosis secondary to alcohol abuse, chronic kidney disease stage 3a, and hypertension who presented with a left-sided pleural effusion and abdominal ascites. A thoracentesis and abdominal paracentesis were performed, and fluid analyses demonstrated a transudative chylothorax with concomitant chylous ascites. In this review, we aim to highlight a rare case of transudative chylothorax and discuss the pathogenesis and management of this condition.

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Section: Discussionmentioning

confidence: 99%

Left-Sided Transudative Chylothorax With Concomitant Chylous Ascites in the Setting of Liver Cirrhosis

Gukasyan¹,

Phan²,

Hu³

et al. 2023

Cureus

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“…Although other drugs may also be effective, β-blockers may effectively treat chylothorax associated with cirrhosis. It has been reported that transjugular intrahepatic portosystemic shunting was effective in the treatment of chylothorax associated with liver cirrhosis [ 10 ]. Tolvaptan has also been reported to be effective in the treatment of ascites associated with liver cirrhosis [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Liver Cirrhosis and Hepatocellular Carcinoma Diagnosed from Chylothorax: A Case Report

Ito

Hachisu

Shibasaki

et al. 2021

Clinics and Practice

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A 71-year-old man visited our hospital with dyspnea and left pleural effusion. Left pleural effusion was diagnosed as chylothorax by thoracentesis. He had no history of trauma or surgery, and there were no findings of malignant lymphoma or thrombosis. Furthermore, he was diagnosed with liver cirrhosis and hepatocellular carcinoma by computed tomography and hematological examinations, and the chylothorax was considered to be caused by liver cirrhosis. We report a review of the literature with this case since it is relatively rare for cirrhosis and hepatocellular carcinoma diagnosed from chylothorax.

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“…Octreotide, a somatostatin analog, has been used successfully in some patients but requires long-term therapy to achieve and maintain consistent symptom control[ 117 ]. Given the rarity of the disease, the evidence on the role of TIPS in this condition is limited to seven case reports and one series of 4 patients[ 118 - 126 ]. Four patients received covered stents, while five patients received bare stents.…”

Section: Hhmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunt in cirrhosis: An exhaustive critical update

Rajesh

George

Philips

et al. 2020

WJG

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More than five decades after it was originally conceptualized as rescue therapy for patients with intractable variceal bleeding, the transjugular intrahepatic portosystemic shunt (TIPS) procedure continues to remain a focus of intense clinical and biomedical research. By the impressive reduction in portal pressure achieved by this intervention, coupled with its minimally invasive nature, TIPS has gained increasing acceptance in the treatment of complications of portal hypertension. The early years of TIPS were plagued by poor long-term patency of the stents and increased incidence of hepatic encephalopathy. Moreover, the diversion of portal flow after placement of TIPS often resulted in derangement of hepatic functions, which was occasionally severe. While the incidence of shunt dysfunction has markedly reduced with the advent of covered stents, hepatic encephalopathy and instances of early liver failure continue to remain a significant issue after TIPS. It has emerged over the years that careful selection of patients and diligent post-procedural care is of paramount importance to optimize the outcome after TIPS. The past twenty years have seen multiple studies redefining the role of TIPS in the management of variceal bleeding and refractory ascites while exploring its application in other complications of cirrhosis like hepatic hydrothorax, portal hypertensive gastropathy, ectopic varices, hepatorenal and hepatopulmonary syndromes, non-tumoral portal vein thrombosis and chylous ascites. It has also been utilized to good effect before extrahepatic abdominal surgery to reduce perioperative morbidity and mortality. The current article aims to review the updated literature on the status of TIPS in the management of patients with liver cirrhosis.

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Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Refractory Transudative Chylothorax due to Liver Cirrhosis

Cited by 3 publications

References 17 publications

Left-Sided Transudative Chylothorax With Concomitant Chylous Ascites in the Setting of Liver Cirrhosis

Left-Sided Transudative Chylothorax With Concomitant Chylous Ascites in the Setting of Liver Cirrhosis

Liver Cirrhosis and Hepatocellular Carcinoma Diagnosed from Chylothorax: A Case Report

Transjugular intrahepatic portosystemic shunt in cirrhosis: An exhaustive critical update

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