In Reply to: Re: Case 1001-04 -- Occult Klatskin Tumor Causing Ascites, Portal Vein Thrombosis and Weight Loss posted by Dan Sze on October 08, 2001 at 20:57:14:
After discovering that he had Klatskin and not idiopathic portal thrombosis, I thought it would be a little too much to recanalize the portal vein. Did not want to put him through that. As was, his bill ended up being $15K (UC Davis billing) and for someone with terminal disease, paying out of his own pocket, I thought it would be unfair. He did not leak through the transhepatic access because everything was done in two days and the tract was not well formed yet. I did do a TIPS once in a lady with Klatskin and she ended up encephalopathic for the rest of her life. Not a very good outcome. The point of this case is that Klatskins can present sometimes in mysterious ways and it can fool even Italian gastroenterologists...