TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT - A SUCCESSFUL TREATMENT FOR HEPATOPULMONARY SYNDROME

Hepatopulmonary syndrome is a well described complication of chronic l iver disease. Though uncommon, it carries a high morbidity and mortali ty, The pathogenesis of the syndrome has not been clearly defined. Por tal hypertension seems to play a crucial role in the pathogenesis of t he syndrome, probably by enhancing nitric oxide production. As yet, no pharmacological therapy has been proven effective. Many reports of su ccessful reversal of the syndrome after liver transplantation have bee n published. We report a patient with hepatopulmonary syndrome who sho wed a significant and durable (4 months') improvement in his symptoms, arterial oxygenation, and intrapulmonary shunts, as calculated by rad ionuclide studies after transjugular intrahepatic portosystemic shunt placement, Transjugular intrahepatic portosystemic shunt may represent a durable treatment option for patients with hepatopulmonary syndrome . (C) 1998 by Am. Cell. of Gastroenterology.