Transjugular intrahepatic porto-systemic stent-shunt for therapy of bleeding esophageal varices due to extramedullary hematopoiesis in primary myelofibrosis: a case report

Onkologie. 2012;35(6):368-71. doi: 10.1159/000338949. Epub 2012 May 21.

Abstract

Background: Primary myelofibrosis belongs to the group of myeloproliferative syndromes. Extramedullary hematopoiesis in the liver can lead to portal hypertension.

Patient and methods: We report a case of a patient with life-threatening, endoscopically not treatable bleeding from esophageal varices due to extramedullary hematopoiesis of the liver that was successfully treated with placement of a transjugular intrahepatic porto-systemic stent-shunt (TIPS).

Results: Therapy of variceal bleeding by TIPS insertion was successful. During a 29-month follow-up, no hepatic failure, hepatic encephalopathy, or further variceal bleeding episode occurred.

Conclusion: TIPS placement is a well-established procedure for the treatment of complications due to portal hypertension mainly due to liver cirrhosis. This report illustrates that TIPS placement can also be a promising treatment option in patients with primary myelofibrosis and portal hypertension due to extramedullary hematopoiesis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Esophageal and Gastric Varices / complications*
  • Esophageal and Gastric Varices / surgery*
  • Gastrointestinal Hemorrhage / complications*
  • Gastrointestinal Hemorrhage / surgery*
  • Hematopoiesis, Extramedullary*
  • Humans
  • Male
  • Portasystemic Shunt, Transjugular Intrahepatic / instrumentation*
  • Portasystemic Shunt, Transjugular Intrahepatic / methods
  • Primary Myelofibrosis / complications*
  • Primary Myelofibrosis / surgery
  • Treatment Outcome