A FISTULA FROM THE PORTAL-VEIN TO THE BILE-DUCT - AN UNUSUAL COMPLICATION OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT

We describe a case of a portal vein bile duct fistula as a complicatio n of transjugular intrahepatic portosystemic shunt (TIPS) placement. T he patient's course was complicated by endocarditis, hemobilia, recurr ent episodes of fever, and bacteremia, followed by liver transplant. T he findings of fever, bacteremia (especially with Gram-negative organi sms), and a decreased hematocrit after shunt placement should raise th e suspicion of an infected shunt with a possible fistula. (Am J Gastro enterol 1998;93:1952-1955. (C) 1998 by Am. Cell. of Gastroenterology).