Superior mesenteric varices and splenic renal shunt with portal hypertension: a case report of liver cirrhosis with complications.
The case of a 58-year old woman with cirrhosis complicated by hepatocellular carcinoma, hepatic encephalopathy and superior mesenteric varices is described. Angiography revealed large superior mesenteric varices and it was demonstrated that the portal venous blood was shunted into the right internal iliac vein via the right ovarian vein. Clinically, this patient had hepatic encephalopathy and hyperammonaemia, but no oesophageal varices were discovered on endoscopy. The hepatic encephalopathy suggested that the portal blood containing ammonium from the superior mesenteric vein entered the brain through the systemic vein without the ammonia being metabolized by the liver.
Department of Internal Medicine, Takasaki National Hospital, Japan.
T
T
Kaji
J
J
Tamura
M
M
Matsumoto
K
K
Hoshino
T
T
Takeuchi
S
S
Sato
H
H
Murakami
S
S
Yano
T
T
Naruse
D006528:Carcinoma, Hepatocellular / Q000150:complications; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000503:physiopathology*; D007084:Iliac Vein / Q000503:physiopathology*; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications; D008642:Mesenteric Veins / Q000503:physiopathology*; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology*; D014648:Varicose Veins / Q000503:physiopathology*