Sonography's Role in the Patient With Transjugular Intrahepatic Portosystemic Shunt

For patients with end-stage liver disease, orthotopic liver transplantation is the only definitive treatment. While awaiting a transplant, many serious complications may occur. Bleeding varices, portal hypertension, and refractory ascites are common sequelae that complicate the treatment of these patients. One form of palliative treatment is the placement of a transjugular intrahepatic portosystemic shunt. Sonography plays an important role in the patient with a transjugular intrahepatic portosystemic shunt. This article discusses the importance of ultrasound throughout the transjugular intrahepatic portosystemic shunt process to include detection of the primary liver disease and its various sequelae, normal alteration in blood flow after placement of transjugular intrahepatic portosystemic shunt, guidelines for the detection of a dysfunctional shunt, and sonographic difficulties in the detection of a dysfunctional shunt.