• Skip to main content
  • Skip to secondary menu
  • Skip to primary sidebar
  • Skip to footer

Life in the Fast Lane • LITFL • Medical Blog

Emergency medicine and critical care medical education blog

  • MENU
  • ECG
  • CCC
  • Top 100
  • PODCASTS
  • JOBS
  • TOX
  • PART ONE
  • INTENSIVE
Home | CCC | Transjugular Intrahepatic Portosystemic Shunt

Transjugular Intrahepatic Portosystemic Shunt

by Dr Chris Nickson, last update April 3, 2019

Reviewed and revised 20th October 2013

OVERVIEW

Transjugular Intrahepatic Portosystemic Shunt Procedure (TIPS) involves accessing the internal jugular vein and IVC to place a stent between the hepatic and portal veins using a needle

  • this provides a conduit between the high pressure portal system and the lower pressure IVC system
  • allows blood to bypass dilated oesophagus and gastric veins
  • used in end stage liver failure

INDICATIONS

  • variceal bleeding refractory to endoscopic banding or pharmacological measure
  • ascites refractory to medical treatment

ANESTHETIC CONSIDERATIONS

  • potential for massive haemorrhage and have a balloon tamponade in place -> resuscitate adequately
  • haemodynamically stable induction
  • invasive monitoring
  • inotropes and blood products at the ready

COMPLICATIONS

  • worsening of hepatic encephalopathy (high risk)
  • pneumothorax
  • arrhythmias
  • massive bleeding
  • infection
  • failure of technique
  • liver capsule perforation
  • stent malposition, displacement or migration
  • stent thrombosis or obstruction

References and Links

LITFL

  • CCC – Gastrointestinal haemorrhage
  • CCC – Upper Gastrointestinal Haemorrhage
  • CCC – Lower Gastrointestinal Haemorrhage
  • CCC – Transjugular Intrahepatic Portosystemic Shunt (TIPS) Procedure

CCC 700 6

Critical Care

Compendium

…more CCC

Share this:

  • Facebook
  • Twitter
  • LinkedIn
  • Print

Related

About Dr Chris Nickson

An oslerphile emergency physician and intensivist suffering from a bad case of knowledge dipsosis. Key areas of interest include: the ED-ICU interface, toxicology, simulation and the free open-access meducation (FOAM) revolution. @Twitter | INTENSIVE| SMACC

Reader Interactions

Leave a Reply Cancel reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Primary Sidebar

  • Twitter
  • Facebook
  • Vimeo
  • LinkedIn
  • Twitter
  • Twitter
  • RSS Feed

Recent Posts

Road to Resus 2: Resus in Emergency

Gender Equality in Healthcare

Paediatric Constipation

Pediatric CXR Cases 008

Funtabulously Frivolous Friday Five 301

Footer

RSS FEED  LITFL posts by EMAIL or RSS

RSS FEED  LITFL Review by EMAIL or RSS

RSS FEED  FFFF by EMAIL or RSS

#FOAMed Medical Education Resources by LITFL is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Based on a work at https://litfl.com

  • Twitter
  • Vimeo
  • Facebook
  • LinkedIn
  • Twitter
  • Twitter

Authors • Blog • Contact • Disclaimer

2018 Launch

  • 23,012,719 visitors

Copyright © 2019 · Powered by vocortex and iSimulate