Reversal of hepatic encephalopathy and alteration in amino acid profiles after blocking a surgical splenorenal shunt by interventional radiological techniques.
Portal-systemic shunts are effective in preventing haemorrhage from varices in portal hypertension, but at the price of hepatic encephalopathy. We describe the blockage of a splenorenal shunt using interventional radiology, in a patient with incapacitating chronic encephalopathy. The procedure successfully reversed encephalopathy, without haemodynamic disturbances or haemorrhage from recurrent varices and was associated with a return of the plasma amino acid profile towards normal, with a reduction in aromatic amino acids and an increase in branch chain amino acids. This observation supports the hypothesis that changes in plasma amino acid profiles in patients with portal-systemic shunting are due to the diversion of portal blood rather than the underlying chronic liver disease.
Clarke
B
B
Department of Medicine, Royal Postgraduate Medical School, London, U.K.
Ellis
M J
MJ
Leung
V
V
Hughes
E
E
Meek
J H
JH
Allison
D J
DJ
Hodgson
H J
HJ
D000596:Amino Acids / Q000097:blood*; D005260:Female; D006501:Hepatic Encephalopathy / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008111:Liver Function Tests; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects*; D011859:Radiography
D000596:Amino Acids