Extrahepatic portosystemic shunt after liver transplantation. Percutaneous embolization for hepatic encephalopathy
| Autor: | J.M. da Silva Gomes Martinho, Elizabeth Balbi, Marcelo Enne, Alexandre Cerqueira, João Luiz Pereira, H.S. Martin, Rodrigo Pereira Diaz André, Lúcio Filgueiras Pacheco-Moreira |
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| Rok vydání: | 2004 |
| Předmět: |
medicine.medical_specialty
Cirrhosis medicine.diagnostic_test business.industry medicine.medical_treatment Liver transplantation medicine.disease Chronic liver disease Inferior vena cava Surgery medicine.vein Radiology Nuclear Medicine and imaging Liver biopsy medicine Portal hypertension Radiology Nuclear Medicine and imaging Portosystemic shunt business Hepatic encephalopathy |
| Zdroj: | Clinical Radiology Extra. 59:116-119 |
| ISSN: | 1477-6804 |
| Popis: | Portal-systemic encephalopathy (PSE) is caused by substances originating in the intestine that directly enter the general circulation without passing through the liver, as in extrahepatic portosystemic shunt (EHPS). This shunt is usually a sequel of cirrhosis and severe portal hypertension. It is seldom observed in neurological complications without portal hypertension and chronic liver disease. The aetiology of portosystemic shunt may involve other rare causes, such as congenital shunts, iatrogenic shunts (after abdominal operation or liver biopsy), trauma and idiopathic shunts. The literature includes only a few cases of portosystemic shunt not associated with portal hypertension, mostly in Western countries. The occlusion of shunts is sometimes indicated for PSE. Recently, good results have been reported for the percutaneous approach using interventional radiology in cases of EHPS occlusion, via the liver or the inferior vena cava. We report a case of a 54-year-old woman presenting with one episode of PSE 27 months after undergoing liver transplantation, without recurrence of cirrhosis or portal hypertension. The portosystemic shunt was diagnosed by abdominal colour-Doppler and magnetic resonance image angiography (MRIA). Spectroscopic cranial MR |
| Databáze: | OpenAIRE |
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