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Impacto clínico da colocação de TIPS
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Em Portugal, a doença hepática terminal provoca cerca de 2000 mortes por ano sendo a nona causa de morte em termos gerais, mas é a quarta causa de morte precoce, isto é, antes dos 70 anos. Destes números, a principal etiologia continua a ser o álcool. Sendo uma doença crónica e apesar da sua mortalidade estar associada principalmente a falência hepática, as suas complicações e consequentes períodos de descompensação são fatores de elevada morbilidade pelo que a sua prevenção e tratamento adequado se revelam essenciais para o aumentar a qualidade de vida e a sobrevivência destes doentes. Este trabalho tem o objetivo de falar sobre o Transjugular intrahepatic portosystemic shunt (TIPS) dado que o mesmo tem se vindo a revelar extremamente eficaz a prevenir ou tratar complicações tais como ascite refratária ou episódios de hemorragia de varizes esofágicas. Além disso, este procedimento permite a estabilização clínica dos doentes atuando como uma ponte para o transplante hepático. No entanto, não sendo um procedimento isento de riscos, acarreta morbidade significativa principalmente devido ao aparecimento ou agravamento de Encefalopatia Hepática (EH) pós-procedimento.
In Portugal, end-stage liver disease causes about 2000 deaths per year, being the ninth leading cause of death, but it is the fourth leading cause of early death, before the age of 70. Among these numbers, the main etiology remains alcohol. Being a chronic disease and although its mortality is mainly associated with hepatic failure, its complications and consequent periods of decompensation are factors of high morbidity and this is the main reason why its prevention and adequate treatment are essential to increase the quality of life and the survival of these patients. This work will describe the Transjugular intrahepatic portosystemic shunt (TIPS) as it has proved to be extremely effective at preventing or treating complications such as refractory ascites or repeated episodes of esophageal variceal hemorrhage. Besides these, this procedure allows the clinic stabilization of its patients which will work as a bridge to hepatic transplant. However, not being a procedure without any risks, it causes significant morbidity mainly due to the onset or deterioration of hepatic encephalopathy (EH) post-procedure.
In Portugal, end-stage liver disease causes about 2000 deaths per year, being the ninth leading cause of death, but it is the fourth leading cause of early death, before the age of 70. Among these numbers, the main etiology remains alcohol. Being a chronic disease and although its mortality is mainly associated with hepatic failure, its complications and consequent periods of decompensation are factors of high morbidity and this is the main reason why its prevention and adequate treatment are essential to increase the quality of life and the survival of these patients. This work will describe the Transjugular intrahepatic portosystemic shunt (TIPS) as it has proved to be extremely effective at preventing or treating complications such as refractory ascites or repeated episodes of esophageal variceal hemorrhage. Besides these, this procedure allows the clinic stabilization of its patients which will work as a bridge to hepatic transplant. However, not being a procedure without any risks, it causes significant morbidity mainly due to the onset or deterioration of hepatic encephalopathy (EH) post-procedure.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
Doença hepática terminal Ascite refratária Encefalopatia hepática Gastroenterologia