TIPSS was successfully performed in a 10-year-old female cystic fibrosis (CF) patient with bleeding gastric varices due to portal hypertension; precipitation of portosystemic encephalopathy later unveiled the presence of a latent colonic stricture associated with high potency pancreatic enzymes. The unusual sequence of events resulting from the co-existence of two CF pathologies are described, and the implications of treatment discussed.
FitzsimmonsSC. The changing epidemiology of cystic fibrosis. J Pediatr1993;122: 1–9.
2.
SmythRLvan VelsenDSmythARLiyodDAHeafDP. Strictures of ascending colon in cystic fibrosis in high-strength pancreatic enzymes. Lancet1994;343:85–86.
3.
KnabeNZakMHansenAMoesgaardJKvistNBeckB. Extensive pathological changes of the colon in cystic fibrosis and high-strength pancreatic enzymes. Lancet1994;343: 1230.
SimpsonKJChalmersNRedheadDNDillonJFFinlaysonNDCHayesPC. Emergency transjugular intrahepatic portasystemic stent shunts to control acute variceal haemorrhage resistant to sclerotherapy. Eur J Gastroenterol Hepatol1994;6:423–428.
6.
KernsSRHawkinsIFJr. Transjugular intrahepatic portosystemic shunt in a child with cystic fibrosis. Am J Roentgenol1992; 159: 1277–1278.
7.
LespoixIVeereman-WautersGWilmsGDe BoeckCVanheuleBEggermontE. Transjugular intrahepatic portosystemic shunt (TIPSS) in a child with cystic fibrosis and oesophageal varices. 20th European Cystic Fibrosis Conference 1995:025 (abstract).