Refractory hepatic encephalopathy due to concomitant transjugular intrahepatic portosystemic shunt and spontaneous mesocaval shunt controlled by embolization of the competitive portosystemic shunt

被引：3

作者：

Cura, Marco ^{[1
]}

机构：

[1] Univ Texas Hlth Sci Ctr San Antonio, Dept Radiol, San Antonio, TX 78229 USA

来源：

CLINICAL IMAGING | 2009年 / 33卷 / 03期

关键词：

Spontaneous mesocaval shunt; Refractory hepatic encephalopathy; Transjugular intrahepatic portosystemic shunt; INTENTIONAL REVERSIBLE THROMBOSIS; PORTAL-HYPERTENSION; STENT; HYPERAMMONEMIA; OCCLUSION; CLOSURE; RISK;

D O I：

10.1016/j.clinimag.2009.01.004

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Spontaneous mesocaval shunt (SMCS) is an uncommon cause of refractory encephalopathy after transjugular intrahepatic portosystemic Shunt (TIPS) creation. We report a patient who presented with refractory hepatic encephalopathy (HE) post-TIPS creation for variceal bleeding in whom a SMCS was found. Percutaneous transhepatic Occlusion of the SMCS reduced the portal vein flow diverted from the liver and provided Sufficient liver perfusion to reverse the HE while maintaining satisfactory decompression of esophageal varices. (C) 2009 Elsevier Inc. All rights reserved.

引用

页码：231 / 233

页数：3

共 25 条

[1]

CARDOSO JE, 1994, HEPATOLOGY, V19, P375

[2] HEPATOPEDAL FLOW RESTORATION IN PATIENTS INTOLERANT OF TOTAL PORTAL DIVERSION [J].

CHANDLER, JG ;

FECHNER, RE .

ANNALS OF SURGERY, 1983, 197 (05) :574-583

[3]

Cordoba J, 1997, AM J GASTROENTEROL, V92, P1429

[4] Transjugular intrahepatic portosystemic shunt constraining stent for the treatment of refractory postprocedural encephalopathy: A simple design utilizing a palmaz stent and wallstent [J].

Forauer, AR ;

McLean, GK .

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 1998, 9 (03) :443-446

[5] COMPLICATIONS OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT - A COMPREHENSIVE REVIEW [J].

FREEDMAN, AM ;

SANYAL, AJ ;

TISNADO, J ;

COLE, PE ;

SHIFFMAN, ML ;

LUKETIC, VA ;

PURDUM, PP ;

DARCY, MD ;

POSNER, MP .

RADIOGRAPHICS, 1993, 13 (06) :1185-1210

[6] REVERSAL OF HEPATIC-ENCEPHALOPATHY AFTER OCCLUSION OF TOTAL PORTASYSTEMIC SHUNTS [J].

HANNA, SS ;

SMITH, RS ;

HENDERSON, JM ;

MILLIKAN, WJ ;

WARREN, WD .

AMERICAN JOURNAL OF SURGERY, 1981, 142 (02) :285-289

[7] INTENTIONAL REVERSIBLE THROMBOSIS OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNTS [J].

HASKAL, ZJ ;

COPE, C ;

SOULEN, MC ;

SHLANSKYGOLDBERG, RD ;

BAUM, RA ;

REDD, DCB .

RADIOLOGY, 1995, 195 (02) :485-488

[8] Non-hepatic hyperammonaemia: an important, potentially reversible cause of encephalopathy [J].

Hawkes, ND ;

Thomas, GAO ;

Jurewicz, A ;

Williams, OM ;

Hillier, CEM ;

McQueen, INF ;

Shortland, G .

POSTGRADUATE MEDICAL JOURNAL, 2001, 77 (913) :717-722

[9] RISK OF INTENTIONAL REVERSIBLE THROMBOSIS OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT [J].

JALAN, R ;

HAYES, PC .

RADIOLOGY, 1995, 197 (03) :587-587

[10] MESENTERIC VENOUS STENOSIS REDUCES HYPERAMMONEMIA IN THE PORTACAVAL-SHUNTED RAT [J].

JOHANSEN, K ;

GIROD, C ;

LEE, SS ;

LEBREC, D .

EUROPEAN SURGICAL RESEARCH, 1990, 22 (03) :170-174

← 1 2 3 →