Background and study aim: Successful transjugular intrahepatic portosystemic shunt (TIPS) insertion effectively lowers the portosystemic pressure gradient, resolves ascites and improves esophageal varices, we studied the effect of TIPS on the grades of gastroesophageal varices and portal hypertensive gastropathy (PHG) in Egyptian patients with Budd-Chiari Syndrome (BCS).
Patients and Methods: This prospective study was conducted at the Tropical Medicine Department; Ain Shams University on 20 patients with confirmed BCS with esophageal, gastric varices and PHG. Upper GI endoscopy was conducted before TIPS. Patients were followed up by upper GIT endoscopy at one and six months after TIPS.
Results: After TIPS, there was a highly significant improvement of portal pressure, (before TIPS: Mean ±SD =24.9±1.9; after TIPS: 8.3±1.5, p-value <0.001) and esophageal varices (EV). In two of three patients with large EV within one-month post-TIPS and in all 3 patients within 6 months post TIPS. 15 patients with medium-sized EV markedly improved to 7 patients reduced to small EV and one reduced to non EV in one month and 9 patients to small EV and 6 reduced to non EV after 6 months and all 2 patients with small EV reduced to non EV after one and six months. After TIPS, there was a highly significant improvement of PHG in most cases.
Conclusion: Successful TIPS insertion in BCS patients leads to improvement in esophageal varices & PHG.