Transjugular intrahepatic portosystemic shunt for pyrrolidine-alkaloid-induced hepatic sinusoidal obstruction syndrome in a patient with situs inversus totalis and portal vein thrombus

Abstract

We here report a rare case of pyrrolidine-alkaloid-induced hepatic sinusoidal obstruction syndrome (PA-HSOS) complicated with situs inversus totalis and portal vein thrombus (PVT). The patient had abdominal distention and ascites, which were not responsive to conservative medical treatment or peritoneal drainage. Transjugular intrahepatic portosystemic shunt (TIPS) was successfully performed in the patient via the left internal jugular vein approach. After the procedure, abdominal distension and ascites gradually resolved. The TIPS procedure could be considered as a useful treatment for PA-HSOS patients with PVT.

Keywords

• case reports; hepatic veno-occlusive disease; portal vein; portasystemic shunt
• transjugular intrahepatic; situs inversus