TIPS treatment in a patient with severe lower gastrointestinal bleeding with a misdiagnosis of cirrhotic portal hypertension.

Abernethy malformation is a rare abnormal embryological development of splanchnic venous system characterised by the presence of a congenital extrahepatic portosystemic shunt. We present a rare case of an adult male patient that was admitted with severe lower gastrointestinal bleeding, requiring multiple blood transfusions. The patient's medical history and the laboratory tests performed led to the misdiagnosis of a congenital Abernethy malformation. We present a rare case, discussing the reasons for the misdiagnosis and we conclude that management of clinical data and imaging are highly important to discard these types of congenital malformations that can mimic a portal hypertension condition

Dispositivo novel para la reducción del TIPS

En la siguiente nota técnica, después de seleccionar adecuadamente a dos pacientes con shunt portosistémico transyugular (TIPS), que presentaron encefalopatía hepática refractaria a medicamentos y pauta conservadora, se implanto un nuevo dispositivo novedoso para la reducción del TIPS empleando un stent con características específicas (sinus-Reduction Stent Vascular®, Optimed, Ettlingen-Alemania) para la reducción del flujo y mejorar el gradiente portosistémico. El procedimiento se llevo acabo mediante un abordaje transyugular y control angiográfico, donde se procedió a implantar dicho stent para disminuir el flujo sanguíneo del TIPS. El objetivo principal de este estudio fue de conocer el resultado técnico, material empleado y la mejoría del cuadro clínico en estos pacientes. In the following technical note, after properly selecting two patients with transjugular portosystemic shunt (TIPS), who presented drug-refractory hepatic encephalopathy, a specific new novel device for TIPS reduction using a stent (sinus-Reduction Stent Vascular®, Optimed, Ettlingen-Germany) was implanted to reduce flow and improve the portosystemic gradient. The procedure was carried out through a transjugular approach and angiographic control, where the stent was implanted to reduce the blood flow of the TIPS. The objective of this study was to determine the technical results, describe specific characteristics of of this device, and evaluate the clinical improvement of the patients