Endoscopic findings of a transjugular intrahepatic portosystemic shunt stent eroding into the biliary tract
A 37-year-old man with cryptogenic cirrhosis and portal hypertension presented for revision of a chronically occluded transjugular intrahepatic portosystemic shunt (TIPS) to manage recurrent esophageal varices. The TIPS was created 6 years prior. The procedure was aborted after purulent, bilious fluid was aspirated during TIPS re-cannulation. He was found to have a total bilirubin of 1.7 mg/dL along with onset of early sepsis postprocedurally. ERCP demonstrated common bile duct irregularities approximating the TIPS stent (A).