Transjugular intrahepatic portosystemic shunt performed in a 2-year-old infant with uncontrollable intestinal bleeding

Although transjugular intrahepatic portosystemic shunt (TIPS) is widely accepted in adults, there have been few successful reports in infants. The authors describe a 2-year-old boy with postoperative biliary atresia who underwent TIPS for uncontrollable lower intestinal bleeding and achieved hemostasis. Massive melena developed, which was not controlled by conservative therapy and devascularization. A shunt was created between the right hepatic vein and the right portal vein with a 6- x 50-mm Wallstent. After TIPS, the porto-systemic pressure gradient decreased from 15 to 11 mm Hg, and collaterals markedly reduced. He has not had recurrent bleeding for over 7 months. TIPS may be a technically feasible and effective treatment to control intestinal bleeding in infants. However. further experience and long-term follow-up will be required. Copyright (C) 2000 by W.B. Saunders Company.