One of the most serious complications, which can occur during transjugular intrahepatic portosystemic shunt (TIPS) creation, is the extrahepatic portal vein puncture, leading to a massive, life-threatening intraperitoneal hemorrhage. Authors report the case of a 59-years old man with liver cirrhosis due to non-alcoholic steatohepatitis and chronic autoimmune hepatitis type II, who developed this complication during shunt creation.
Immediately after the diagnosis of contrast media extravasation, an angioplasty balloon was used for occlusion of the lacerated portal vein, with urgent stent-graft placement. This procedure, together with an adequate fluid replacement, led to patient's hemodynamic stabilisation.