Portal-systemic encephalopathy from a spontaneous gastrorenal shunt diagnosed by three-dimensional computed tomography and treated effectively by percutaneous vascular embolization.
A 67-year-old man with a portal-systemic shunt confirmed by three-dimensional computed tomography (3D-CT) was successfully treated by percutaneous vascular embolization. The patient had aggravated loss of memory, disorientation, and hyperammonemia. A gastrorenal shunt 16 mm in diameter was found by 3D-CT reconstructed by helical computed tomography (CT). Embolization was performed only in the shunt percutaneously through the inferior vena cava. One year after the embolization, no recurrence of portal-systemic encephalopathy and no portal hypertension have appeared, and the clinical course has been good.
Second Department of Internal Medicine, Akita City Hospital, Kawamoto, Japan.
T
T
Kuramitsu
M
M
Komatsu
N
N
Matsudaira
T
T
Naganuma
M
M
Niizawa
A
A
Zeniya
T
T
Yoshida
I
I
Toyoshima
M
M
Chiba
O
O
Masamune
D000368:Aged; D003097:Collateral Circulation; D004621:Embolization, Therapeutic; D005260:Female; D006501:Hepatic Encephalopathy / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000503:physiopathology; D011169:Portal Vein; D011859:Radiography; D012082:Renal Veins