Congenital Portal Systemic Encephalopathy Misdiagnosed as Senile Dementia
| Autor: | Michi Kondo, Tetsushi Nasu, Ryutaro Nakao, Akiko Uno, Tokuro Muroki, Kaori Miyata, Akira Kawashima, Masao Ichinose, Taisei Nakao, Hideyuki Tamai |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
Radiography Abdominal medicine.medical_specialty Cirrhosis Portal venous pressure Balloon Inferior vena cava Alzheimer Disease Ammonia Internal Medicine medicine Humans Mesentery Diagnostic Errors Aged 80 and over business.industry Angiography General Medicine medicine.disease Shunt (medical) Surgery medicine.anatomical_structure medicine.vein Hepatic Encephalopathy Portal hypertension Abdomen Radiology Gonadal vein business |
| Zdroj: | Internal Medicine. 48:321-324 |
| ISSN: | 1349-7235 0918-2918 |
| Popis: | Congenital portal systemic encephalopathy without liver cirrhosis and/or portal hypertension is rare. An 86-year-old man with senile dementia was admitted due to disturbance of consciousness. His serum ammonia level was high, but there was no evidence of liver cirrhosis or portal hypertension on laboratory tests and upper abdominal enhanced computed tomography (CT). However, on lower abdominal enhanced CT, a meso-caval shunt was found in the right lower abdomen. Superior mesenteric arteriography revealed a shunt flowing into the inferior vena cava via the right gonadal vein. The shunt was closed by balloon occluded retrograde transvenous obliteration, and dementia-like symptoms improved. |
| Databáze: | OpenAIRE |
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