Korean J Gastroenterol.  2010 Sep;56(3):125-127. 10.4166/kjg.2010.56.3.125.

Type 2 Hepatorenal Syndrome in a Cirrhotic Patient Who Underwent Gastric Cancer Surgery

• Kim JW

• KMID: 948774
• DOI: http://doi.org/10.4166/kjg.2010.56.3.125

Abstract

No abstract available.

MeSH Terms

Adult
Hepatitis C/diagnosis
Hepatorenal Syndrome/*diagnosis/drug therapy/surgery
Humans
Liver Cirrhosis/*diagnosis
Lypressin/analogs & derivatives/therapeutic use
Male
Portasystemic Shunt, Transjugular Intrahepatic
Stomach Neoplasms/*surgery
Tomography, X-Ray Computed
Vasoconstrictor Agents/therapeutic use

Figure

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  Fig. 1. Abdominal CT scan of the patient before (A) and 18 days after (B) total gastrectomy. Preoperative CT showed features of chronic liver disease without ascites. Postoperative CT showed large amount of ascites and slightly decreased liver volume. Abdominal CT scan after admission to our hospital (C) showed similar findings. After TIPS, ascites decreased slightly, with longer intervals of therapeutic paracentesis (D). TIPS, transjugular intrahepatic portosystemic shunt.

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  Fig. 2. Hospital course of the patient. See text for details. TIPS, transjugular intrahepatic portosystemic shunt.

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  Fig. 3. Transjugular intrahepatic portosystemic shunt for the management of type 2 hepatorenal syndrome developed in HCV-related cirrhotic patient who underwent radical total gastrectomy. IVC pressure was measured as 11 mmHg. Portal vein was punctured from hepatic vein and main portal vein pressure was measured as 25 mmHg (A) The tract was dilated with a balloon catheter, and 10 mm×7 cm stent was deployed (B). Main portal vein pressure dropped to 21 mmHg after the procedure. Stent stenosis was detected on day 154 (C), and portal venous pressure rose to 26 mmHg. After balloon dilatation, the portal pressure reduced back to 17 mmHg (D).

Reference

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