{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T16:41:35Z","timestamp":1774888895857,"version":"3.50.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    This article reports the case of a 73-year-old man with a 50-year history of long-term alcohol abuse (with daily intake of 250\u202fg) combined with primary biliary cholangitis (PBC, AMA-M2 positive). The patient recently developed refractory ascites and manifestations of portal hypertension (hepatic venous pressure gradient, HVPG: 17.3\u202fmmHg). Liver biopsy revealed characteristic sinusoidal dilation and congestion, fibrosis, and erythrocyte extravasation. It was discovered that the patient had a history of consuming\n                    <jats:italic>Gynura segetum<\/jats:italic>\n                    (a traditional Chinese herb) for 1\u202fyear. Based on clinical presentation and diagnostic findings, the final diagnosis included the following: (1) hepatic veno-occlusive disease\/sinusoidal obstruction syndrome (VOD\/SOS), (2) portal hypertension, (3) primary biliary cholangitis (PBC), and (4) alcoholic cirrhosis. After a poor response to medical treatment, a transjugular intrahepatic portosystemic shunt (TIPS) was performed, resulting in significant improvement (postoperative portal pressure gradient (PPG) decreased to 8\u202fmmHg, with complete resolution of ascites). During a 6-month follow-up, liver function showed marked improvement, with the Child\u2013Pugh score improving from class C (11 points) to class A (6 points).\n                  <\/jats:p>","DOI":"10.3389\/fmed.2025.1696892","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T05:13:30Z","timestamp":1764220410000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Transjugular intrahepatic portosystemic shunt for hepatic sinusoidal obstruction syndrome with primary biliary cholangitis and alcoholic liver disease: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Pei","family":"Yang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingrong","family":"Qian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3753","DOI":"10.3748\/wjg.v25.i28.3753","article-title":"Pyrrolizidine 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cirrhosis: relationship with histological features","volume":"5","author":"Navasa","year":"1987","journal-title":"J Hepatol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1097\/MEG.0000000000002591","article-title":"Transjugular intrahepatic portosystemic shunt for pyrrolidine alkaloids-induced hepatic sinusoidal obstruction syndrome: a retrospective cohort study","volume":"35","author":"Huang","year":"2023","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.jhep.2025.01.029","article-title":"EASL clinical practice guidelines on TIPS","volume":"83","year":"2025","journal-title":"J Hepatol"}],"container-title":["Frontiers in 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