Salvage TIPS for refractory variceal bleeding after failed port-systemic shunt surgery in a patient with non cirrhotic portal hypertension

Abstract In patients with refractory variceal bleed and well preserved liver function (Childs class A and B) surgical shunt and transjugular intrahepatic portosystemic shunt (TIPS) are the only few options available. The long-term survival depends on the severity of underlying liver disease, rather than on the variceal bleeding per se(1). Efficacy of TIPS in preventing variceal bleed is almost similar in comparison to splenorenal shunt (SRS) which may be a more cost effective option(2). Both have been used as salvage therapy for refractory variceal bleeding. We herein report a case of refractory variceal bleed after failed distal spleno-renal shunt managed with emergency TIPS in a patient with non cirrhotic portal hypertension.