Intra-hepatic haematoma complicating transjugular intra-hepatic portosystemic shunt for Budd-Chiari syndrome associated with anti-phospholipid antibodies, aplastic anaemia and chronic hepatitis C

Portal venous decompression with transjugular intra-hepatic portosystemic s hunt (TIPS) is a new approach in the treatment of Budd-Chiari syndrome. We report on a 31-year-old female with Budd-Chiari syndrome due to anti-phosph olipid antibodies with compression of the inferior vena cava treated with T IPS and stenting of the inferior vena cava. TIPS was complicated by massive intra-hepatic haematoma which was managed conservatively. Treatment option s and pathogenic mechanisms of Budd-Chiari syndrome under the rare coincide nce of aplastic anaemia and anti-phospholipid syndrome are discussed. TIPS may be considered for venous decompression in Budd-Chiari syndrome, but phy sicians should be aware of potential TIPS' complications in these patients. Eur J Gastroenterol Hepatol 12:813-816 (C) 2000 Lippincott Williams & Wilk ins.