Two cases of alcoholic liver cirrhosis with diffuse intrahepatic arterio-portal shunt treated by transjugular intrahepatic portosystemic shunt

Case 1 was a 56 year old man with alcoholic liver cirrhosis and refractory ascites and pleural effusion. Hepatofugal portal blood flow from diffuse Arterio-portal shunt (A-P shunt) was observed throughout the liver in the hepatic arteriography. Transjugular intrahepatic portosystemic shunt (TIPS) was performed for the treatment of refractory ascites and the pleural effusion. After TIPS, ascites and pleural effusion was almost disappeared. Case 2 was a 70 year old man with alcoholic liver cirrhosis and refractory ascites. A-P shunt was observed throughout the liver in the hepatic arteriography and portal blood flow was demonstrated as hepatofugal. TIPS was performed for the treatment of refractory ascites. After TIPS, ascites was decreased. TIPS may be effective for the treatment of refractory ascites due to diffuse intrahepatic A-P shunt.