Transjugular intrahepatic portosystemic shunt as a feasible option for portal hypertension due to Porto-sinusoidal vascular disorder: a case report.

Porto-sinusoidal vascular disorder (PSVD) was defined by the Vascular Liver Disease Interest Group in 2019 and encompasses conditions that cause portal hypertension in patients without cirrhosis. Nodular regenerative hyperplasia (NRH) is a pathological finding associated with PSVD. We encountered a patient with refractory ascites who underwent transjugular liver biopsy and was diagnosed with PSVD. The patient subsequently underwent transjugular intrahepatic portosystemic shunt (TIPS) placement for refractory ascites and recurrent variceal bleeding caused by portal hypertension, which resolved the ascites and improved the varices. Post-procedural complications, including hepatic ischemia, portal vein thrombosis, and hepatic encephalopathy, were observed but improved with conservative treatment. TIPS can be a feasible treatment option for patients with portal hypertension associated with non-cirrhotic conditions such as PSVD.