In Reply to: Re: Case 0100_06 -- Management of Acute Liver Failure in a Patient with Portal and Hepatic Vein Thrombosis posted by Grant Price on January 06, 19100 at 18:53:33:
As for etiology..I think your guess is as good as anybodies. My feeling Hep C was major contributer, but Hep B,C and alcohol; Most likely acted together to multiply effect more than additive effect.
Since most sources mention tips as a possible source of liver failure itself robbing the liver of a major portal blood supply, I would have to assume, Yes, acute Portal vein thrombosis would similarly induce the liver failure.
As far as this patient goes, I think you had nothing to lose by trying and you gave a valient effort. However, you likely were dealing with a no win situation.
Althogh TIPS itself probably is one of our most challenging and possibly rewarding procedures when it works. With our statistics so far, even questioning any improvement in mortality from this procedure. I feel we have to look at how far do we want to go with these extreme cases....And should we even be performing them in all but most cases of Child's A and possibly B disease. My own feeling for extreme cases is that if they are not a liver transplant candidate who we are buying time for. Then perhaps we must admit we are wasting our time and resources for too little to gain.