TIPS and Surgical Shunts

TIPS and surgical shunts are considered as salvage therapies to control acute variceal hemorrhage. Ten to 20% of patients will continue to bleed despite endoscopic treatment. TIPS and shunts are extremely effective procedures with control rates approaching 95%. TIPS involves the placement of an expandable metal stent from the hepatic vein, through the liver parenchyma, into the portal vein. Stents are the preferred form of salvage therapy as they can be successfully implanted in almost all patients and decrease the HVPG by half. An alternative to TIPS in Child's A cirrhotics is surgical shunting, which decompresses the portal system by creating a portasystemic anastomosis. Unfortunately, despite their high rate of success in controlling variceal hemorrhage, TIPS and surgical shunts are associated with many significant side effects, including hepatic encephalopathy and worsening liver failure, resulting in higher overall mortality rates.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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