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Embolization of the left portal vein to inferior vena cava shunts for chronic recurrent hepatic encephalopathy via the mesenteric vein
Author(s) -
Takayama Yuichi,
Moriura Shigeaki,
Nagata Junichi,
Akutagawa Atsushi,
Hirano Atsushi,
Ishiguro Seiji,
Matsumoto Takatoshi,
Sato Taichiro
Publication year - 2001
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2001.02508.x
Subject(s) - medicine , portography , radiology , inferior vena cava , cirrhosis , embolization , hepatic encephalopathy , hyperammonemia , encephalopathy , ascites , portal venous pressure , superior mesenteric vein , portal hypertension , right gastric vein , splenic vein , laparotomy , surgery , portal vein
Abstract Diagnostic imaging and embolization therapy for very rare intrahepatic portal‐systemic shunts with liver cirrhosis are reported. An 82‐year‐old woman was admitted to the hospital (Yachiyo Hospital) because of hepatic encephalopathy. Computed tomography with contrast enhancement demonstrated anomalous vessels between the portal vein and the inferior vena cava. Those shunts were suspected as the cause of her encephalopathy with hyperammonemia. Portography through McBurney's laparotomy demonstrated two portal‐caval shunts; one was from the bifurcation of the portal vein and the other was from the left portal vein. They seemed to originate from the vascular system of the caudate lobe, and were obstructed with stainless coils. The patient is well with a normal serum ammonia level 40 months following the intervention.