Transjugular Intrahepatic Portosystemic Shunt

Figure 1. Transjugular Intrahepatic Portosystemic Shunt. This hepatic Doppler sonogram in a 55-year-old man with alcoholic cirrhosis and portal hypertension shows the successful placement of a transjugular intrahepatic portosystemic shunt. The procedure was performed because of refractory and debilitating ascites. The shunt shows characteristic echogenicity (solid arrows), along with an intense (blue) signal from the shunted blood. Ascites (open arrow) is present anterior to the liver. After the placement of the shunt, the patient's esophageal varices regressed and the ascites improved without further therapy, until the shunt became thrombosed eight months later. The patient is currently awaiting liver transplantation.