Combined Balloon-, Plug- and Coil-assisted Retrograde Transvenous Obliteration of Multiple Portosystemic Shunts to Treat Recurrent Hepatic Encephalopathy: A Case Report
| Autor: | Amar Mukund, Shiv Kumar Sarin, Karan Manoj Anandpara |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Hepatology business.industry Portal venous pressure Case Report Vascular plug medicine.disease Balloon Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis medicine HE - Hepatic encephalopathy Portal hypertension 030211 gastroenterology & hepatology Erratum Clinical failure business Hepatic encephalopathy Shunt (electrical) |
| Zdroj: | J Clin Exp Hepatol |
| ISSN: | 0973-6883 |
| DOI: | 10.1016/j.jceh.2019.12.002 |
| Popis: | Balloon- or plug-assisted retrograde transvenous obliteration of portosystemic shunts is an effective endovascular technique for the treatment of type B bypass hepatic encephalopathy. We describe a patient who underwent balloon- and plug-assisted obliteration for a lienorenal and lienogonadal shunt, respectively. He returned with symptoms of recurrent hepatic encephalopathy two years later due to reformation of new lienorenal and lienogonadal shunts. Repeat obliteration of these new shunts was now performed using balloon and coil assistance. We describe the treatment for multiple portosystemic shunts with combined usage of vascular plug, balloon and coils depending on anatomical and technically factors. Our case also highlights that after shunt obliteration increased portal pressure may form new portosystemic collateral pathways which leads to clinical failure and may require repeat treatment. |
| Databáze: | OpenAIRE |
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