Post-TIPS Hepatic Encephalopathy — RACP Adult Medicine MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: E — Hepatic encephalopathy
Hepatic encephalopathy is the most common complication of TIPS, occurring in 20–30% of patients. The shunt diverts portal blood (containing gut-derived toxins including ammonia) directly into the systemic circulation, bypassing hepatic metabolism. Management includes lactulose and rifaximin. In severe refractory cases, TIPS diameter reduction may be necessary. Pre-TIPS assessment of hepatic reserve (MELD score, prior HE history) helps predict this complication.
Reference: eTG – 2025 – Gastrointestinal; EASL – 2018 – Decompensated Cirrhosis Guidelines