BACKGROUND: Liver cirrhosis patients can develop various complications including bacteremia as the intestinal flora is heterologous. In those with low immunity, trauma, or following surgery, CASE SUMMARY: A male patient with decompensated cirrhosis experienced multiple episodes of gastrointestinal bleeding and hypersplenism. He was admitted to hospital due to voluntary remedial TIPS. The patient developed a numerous intrahepatic liver abscess postoperatively. Following initial conservative treatment with intravenous antibiotics and parenteral nutrition, three months after TIPS, the liver abscess had disappeared on imaging examination. At the 6-month postoperative follow-up, outpatient re-examination showed that the patient had recovered and the liver abscess had resolved. CONCLUSION: Attention should be paid to decreased blood cell counts, especially low leukocyte levels in patients with liver cirrhosis as the presence of intestinal microbiota dysregulation and portal pyemia can result in liver abscess and sepsis during invasive diagnostic and therapeutic procedures like TIPS. The addition of probiotics might reduce the risk in such patients.