Transjugular Intrahepatic Portosystemic Shunts and Surgical Shunts

Surgical shunts are effective in the primary prevention of variceal bleeding, and they were historically used to this end. However, due to the high rate of postprocedure hepatic encephalopathy, and because patients undergoing portacaval shunts have decreased survival rates compared with controls, surgical shunts are no longer used for primary prophylaxis. There is no data supporting the use of transjugular intrahepatic portosystemic shunts (TIPS) for the primary prevention of variceal bleeding. TIPS is reserved for salvage therapy for variceal hemorrhage, recurrent variceal hemorrhage despite adequate first line therapy, refractory ascites, and bleeding isolated gastric fundal varices.

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.

Get My Free Ebook


Post a comment