Twenty-five years after the first TIPS in Spain. / Veinticinco años tras los primeros TIPS en España.

The incorporation, 25 years ago, of transjugular intrahepatic portosystemic shunting, better known by the acronym TIPS, represents an indisputable improvement in the treatment and management of patients with symptoms due to portal hypertension. This article discusses the origins of the technique and the technical innovations that have been progressively added through the years. The implantation of coated stents, which protect the stent from processes in the parenchymal track that can lead to stenosis, have helped ensure long-term patency, thus reducing the need for reintervention. Solid evidence from valuable publications has situated TIPS at the forefront of the treatment options in a wide variety of clinical situations associated with portal hypertension.

[Direct embolization of stomal varices in portal hypertension after the treatment of liver metastases]. / Embolización directa de varices estomales en la hipertensión portal tras el tratamiento de metástasis hepáticas.

We present the case of a man with a history of colorectal carcinoma and metastatic liver involvement who developed portal hypertension and recurrent bleeding from stomal varices after treatment with intra-arterial oxaliplatin and radioembolization with yttrium-90 microspheres. The definitive treatment for the bleeding episodes was embolization of the varices with coils using a direct percutaneous approach.

Partial splenic embolisation and improvement of hypersplenism before liver transplantation.

A case of partial splenic embolisation (PSE) that was performed in a girl with severe leucothrombocytopenia due to hypersplenism is described. Treatment with PSE is a safe and effective alternative to splenectomy that prevents clinical complications due to haematological disorders and improves hypersplenism before liver transplantation.

[Periportal adenitis secondary to abdominal tuberculosis. A CT study]. / Adenitis periportal secundaria a tuberculosis abdominal. Estudio mediante TC.

Isolated periportal tuberculous adenitis is rare. Computed tomography (TC) is the primary modality for its detection and evaluation. Although not definitive, in the presence of an appropriate clinical history and a positive purified protein derivative test, a diagnosis of periportal tuberculous lymphadenopathy may be suggested by CT by the presence of low-density enlarged porta hepatis lymph nodes with immediate postcontrast peripheral rim enhancement.

[A case of idiopathic retropneumoperitoneum, pneumoperitoneum, pneumomediastinum and subcutaneous emphysema]. / A propósito de un caso de retroneumoperitoneo, neumoperitoneo, neumomediastino y enfisema subcutáneo idiopáticos.

We present a case of retropneumoperitoneum , pneumoperitoneum , pneumomediastinum and subcutaneous emphysema in a caquectic 17 years old young man with an important depressive disorder . Several possible etiopathogenic factors are discussed, as well as the pathways of transmission of the pulmonary , mediastinic and abdominal gas.