Surgical treatment of a patient with idiopathic portal hypertension and hepatic encephalopathy.
Idiopathic portal hypertension is clinically characterized by splenomegaly and portal hypertension. Hepatic encephalopathy is rare in cases with idiopathic portal hypertension. In a 59-year-old man with recurrent hepatic encephalopathy for one year, a large splenorenal shunt was detected in the computed tomography and angiography, and liver biopsy revealed a portal fibrosis consistent with idiopathic portal hypertension. Devascularization of the upper stomach, splenectomy and closure of the splenorenal shunt were done. The patient has had no experience of encephalopathy since the operation even without drug treatment. Surgery should be considered for treatment of chronic hepatic encephalopathy in patients with idiopathic portal hypertension and portosystemic shunts.
Ohta
M
M
Department of Surgery II, Kyushu University, Fukuoka, Japan.
Shimada
T
T
Matsufuji
H
H
Yukizane
T
T
Yamada
H
H
Sugimachi
K
K
D000792:Angiography; D001284:Atrophy; D003097:Collateral Circulation / Q000502:physiology; D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000601:surgery*; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012082:Renal Veins / Q000601:surgery; D013156:Splenectomy; D013162:Splenic Vein / Q000601:surgery*; D013270:Stomach / Q000098:blood supply; D014057:Tomography, X-Ray Computed