Numerous liver abscesses after transjugular intrahepatic portosystemic shunt for decompensated liver cirrhosis: A case report.

Abstract

Background: Liver cirrhosis patients can develop various complications including bacteremia as the intestinal flora is heterologous. In those with low immunity, trauma, or following surgery, etc., the body is susceptible to concurrent systemic or local infections. Under these circumstances, even minimally invasive treatment methods such as interventional therapy like transjugular intrahepatic portosystemic shunt (TIPS) for liver cirrhosis patients can also result in complications such as infections.

Case summary: A male patient with decompensated cirrhosis experienced multiple episodes of gastrointestinal bleeding and hypersplenism. He was admitted to hospital due to voluntary remedial TIPS. The patient developed a numerous intrahepatic liver abscess postoperatively. Following initial conservative treatment with intravenous antibiotics and parenteral nutrition, three months after TIPS, the liver abscess had disappeared on imaging examination. At the 6-month postoperative follow-up, outpatient re-examination showed that the patient had recovered and the liver abscess had resolved.

Conclusion: Attention should be paid to decreased blood cell counts, especially low leukocyte levels in patients with liver cirrhosis as the presence of intestinal microbiota dysregulation and portal pyemia can result in liver abscess and sepsis during invasive diagnostic and therapeutic procedures like TIPS. The addition of probiotics might reduce the risk in such patients.