Q; After successful completion of Transjugular Intrahepatic Porto-systemic Shunt (TIPS) for variceal bleeding - hepatic encephalopathy __________? (select one)
A) tends to get better
B) tends to get worse
C) It has nothing to do with TIPS
Answer: B
Hepatic encephalopathy tends to get worse after the successful completion of TIPS. Due to shunting, blood flow to the liver is reduced, which might result in increased toxic substances reaching the brain without being metabolized first by the liver. It can be treated medically through diet, lactulose, or narrowing the shunt by inserting a reducing stent.
#hepatology
References:
1. Treatment for hepatic encephalopathy: tips from TIPS? - Journal of Hepatology 42 (2005) 626–628
2. Hepatic encephalopathy after TIPS-- retrospective study - Vnitr Lek. 2002 May;48(5):390-5
3. Madoff DC, Wallace MJ. Reduced stents and stent-grafts for the management of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt creation. Semin Intervent Radiol. 2005 Dec;22(4):316-28. doi: 10.1055/s-2005-925558. PMID: 21326710; PMCID: PMC3036296.
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