Biliary Obstruction Secondary to Transjugular Intrahepatic Portosystemic Shunt Presenting as Alcohol-Associated Hepatitis.

Transjugular portosystemic intrahepatic shunt (TIPS) is a procedure used to alleviate portal hypertension. The two most common clinical indications for TIPS are secondary prevention of variceal hemorrhage and refractory ascites. Biliary complications, of which biliary-shunt fistulas are the most common, are very rare. There are very limited data on TIPS placement leading to biliary obstruction. We describe a patient who underwent TIPS placement leading to biliary obstruction, initially thought to have alcohol-associated hepatitis, who was successfully treated with interventional radiology-guided percutaneous biliary drain placement.