Ir. Willner et al., A FISTULA FROM THE PORTAL-VEIN TO THE BILE-DUCT - AN UNUSUAL COMPLICATION OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT, The American journal of gastroenterology, 93(10), 1998, pp. 1952-1955
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).