ACUTE ESOPHAGEAL VARICEAL BLEEDING AND PO RTAL-VEIN THROMBOSIS AS COMPLICATION AFTER TIPSS - AN UNUSUAL EMERGENCY INDICATION FOR LIVER-TRANSPLANTATION

Acute oesophageal variceal bleeding is a severe complication of portal hypertension caused by liver cirrhosis. The mortality of the first bl eeding runs up to 50 %. Recurrent bleeding deteriorates the long-term prognosis. The therapy of first choice for acute oesophageal haemorrha ge is endoscopic sclerotherapy. A new option to decompress portal hype rtension for patients who continue to bleed despite sclerotherapy is T IPSS-implantation. We report on a patient suffering from recurrent oes ophageal haemorrhage caused by portal hypertension due to postalcoholi c liver cirrhosis, who developed a portal vein thrombosis after TIPSS- implantation. TIPSS-procedure permitted a bridging period for five mon ths, until eventually a severe uncontrollable oesophageal haemorrhage occurred and emergency liver transplantation was needed. The patient w as discharged after 6 weeks from the hospital in excellent condition.