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Title of Journal: Cardiovasc Intervent Radiol

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Abbravation: CardioVascular and Interventional Radiology

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Springer US

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DOI

10.1007/bf02970482

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1432-086X

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Two Unusual but Treatable Causes of Refractory Asc

Authors: P M Novelli J Shields V Krishnamurthy K Cho
Publish Date: 2015/05/28
Volume: 38, Issue: 6, Pages: 1663-1669
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Abstract

Refractory ascites RA is thought to complicate the postoperative course of 5–7  Nishida et al in Am J Transplant 6 140–149 2006 Gotthardt et al in Ann Transplant 18 378–383 2013 of liver transplant recipients RA after liver transplantation is often a frustrating diagnostic dilemma with few good management options unless an obvious mechanical factor is identified Supportive therapies often fail until a treatable precipitating cause is identified and removed We describe two patients who developed RA following liver transplantation for primary sclerosing cholangitis and hepatitis C and alcoholic liver disease respectively The cause for RA was hyperkinetic portal hypertension secondary to splenomegaly in the first case and a pancreatic AVM in the 2nd case After failure of other interventions surgical splenectomy resulted in immediate and durable resolution of the previously intractable ascites

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