Luo SH, Wang ZH, Chen J, Chen JY. Numerous liver abscesses after transjugular intrahepatic portosystemic shunt for decompensated liver cirrhosis: A case report. World J Radiol 2025; 17(2): 101932 [DOI: 10.4329/wjr.v17.i2.101932]
Corresponding Author of This Article
Jian-Yong Chen, MD, PhD, Chief Doctor, Professor, Department of Gastroenterology and Hepatology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, No. 152 Aiguo Road, Donghu district, Nanchang 330006, Jiangxi Province, China. cjyacy69@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Feb 28, 2025; 17(2): 101932 Published online Feb 28, 2025. doi: 10.4329/wjr.v17.i2.101932
Numerous liver abscesses after transjugular intrahepatic portosystemic shunt for decompensated liver cirrhosis: A case report
Shi-Hua Luo, Zhao-Han Wang, Jie Chen, Jian-Yong Chen
Shi-Hua Luo, Zhao-Han Wang, Jie Chen, Jian-Yong Chen, Department of Gastroenterology and Hepatology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330006, Jiangxi Province, China
Author contributions: Luo SH wrote the paper; Wang ZH performed the research; Luo SH analyzed the data and revised the paper; Chen JY supervised the paper; all authors have read and approved the final version to be published.
Informed consent statement: Written informed consent was acquired from the parents of the patient.
Conflict-of-interest statement: The authors declared that they do not conflict of interest with respect to this manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Yong Chen, MD, PhD, Chief Doctor, Professor, Department of Gastroenterology and Hepatology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, No. 152 Aiguo Road, Donghu district, Nanchang 330006, Jiangxi Province, China. cjyacy69@163.com
Received: October 1, 2024 Revised: December 16, 2024 Accepted: January 23, 2025 Published online: February 28, 2025 Processing time: 147 Days and 20.7 Hours
Abstract
BACKGROUND
Liver cirrhosis patients can develop various complications including bacteremia as the intestinal flora is heterologous. In those with low immunity, trauma, or following surgery, etc., the body is susceptible to concurrent systemic or local infections. Under these circumstances, even minimally invasive treatment methods such as interventional therapy like transjugular intrahepatic portosystemic shunt (TIPS) for liver cirrhosis patients can also result in complications such as infections.
CASE SUMMARY
A male patient with decompensated cirrhosis experienced multiple episodes of gastrointestinal bleeding and hypersplenism. He was admitted to hospital due to voluntary remedial TIPS. The patient developed a numerous intrahepatic liver abscess postoperatively. Following initial conservative treatment with intravenous antibiotics and parenteral nutrition, three months after TIPS, the liver abscess had disappeared on imaging examination. At the 6-month postoperative follow-up, outpatient re-examination showed that the patient had recovered and the liver abscess had resolved.
CONCLUSION
Attention should be paid to decreased blood cell counts, especially low leukocyte levels in patients with liver cirrhosis as the presence of intestinal microbiota dysregulation and portal pyemia can result in liver abscess and sepsis during invasive diagnostic and therapeutic procedures like TIPS. The addition of probiotics might reduce the risk in such patients.
Core Tip: Transjugular intrahepatic portosystemic shunt (TIPS) is currently used for the treatment of portal hypertension and its complications though numerous liver abscesses induced by such interventional minimally invasive treatment is uncommon. We report a case of numerous hepatic abscesses in a patient with decompensated cirrhosis postoperatively after TIPS. Following prolonged conservative treatment with intravenous antibiotics and supportive therapy, the liver abscesses disappeared, and the patient recovered completely.
