TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT AS A TREATMENT FOR PROTEIN-LOSING ENTEROPATHY CAUSED BY PORTAL-HYPERTENSION

A case of a 41-year-old man with diarrhea, hypoalbuminemia, and crypto genic cirrhosis with features of portal hypertension is described, Pro tein-losing enteropathy was confirmed by analysis of whole-gut ravage fluid, and intestinal inflammation and infection were excluded, Distal duodenal biopsy specimens showed evidence of edematous villi with pro minent submucosal vascular and lymphatic vessels. A transjugular intra hepatic portosystemic stent-shunt was inserted, resulting in resolutio n of both his diarrhea and elevated whole gut lavage fluid protein con centrations. His symptoms recurred and then again improved after shunt thrombosis and parallel shunt placement, respectively. Histological i mprovement of the villous edema was also noted. This is the first reco rded case of protein-losing enteropathy caused by portal hypertension confirmed by successful treatment with transjugular intrahepatic porto systemic stent-shunt.