Portal vein invasion and cavernous transformation secondary to hepatic echinococcosis successfully managed by TIPS: a case report and literature review.
Bao Yingjun, Zhang Yuan, Zhu Diwen et al.
✦ AI-curated · Sources linked
Case in brief
A 44-year-old woman with recurrent gastrointestinal bleeding had a history of right hepatectomy for hepatic alveolar echinococcosis. CT and ultrasound showed portal vein invasion with cavernous transformation, causing portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) was successfully performed, reducing the portosystemic pressure gradient from 22 mmHg to 9 mmHg.
What made this case unusual
The case links hepatic echinococcosis with portal vein invasion and cavernous transformation presenting as portal hypertension-related gastrointestinal bleeding, and reports successful TIPS despite these vascular changes.
Diagnostic / clinical pearl
In a patient with hepatic echinococcosis and gastrointestinal bleeding, consider portal vein invasion with cavernous transformation as a cause of portal hypertension.
Why it matters
The report describes TIPS as a potential option for gastrointestinal bleeding associated with portal hypertension in this setting, where medical therapy may be poorly effective for severe complications.