Hepatic encephalopathy due to intrahepatic portosystemic venous shunt successfully treated by interventional radiology.
We treated a 66-year-old woman with hepatic encephalopathy secondarily induced by an intrahepatic portosystemic venous shunt (IPSVS). In serial observations, the volume of the liver became smaller and encephalopathy could not be controlled with conservative therapy. We occluded the IPSVS successfully using percutaneous transcatheter embolization with micro coils. Following embolization, encephalopathy disappeared and blood flow of all branches of portal vein improved. In cases with an IPSVS without liver cirrhosis, blood flow in the portal vein and liver volume must be followed carefully, and interventional radiology may be considered effective in those who do not show a satisfactory response to conservative therapy.
Hiraoka
Atsushi
A
Third Department of Internal Medicine, Ehime University of Medicine, Toon, Ehime 791-0295.
Kurose
Kiyotaka
K
Hamada
Maho
M
Azemoto
Nobuaki
N
Tokumoto
Yoshio
Y
Hirooka
Masashi
M
Hasebe
Aki
A
Kumagi
Teru
T
Hirata
Mami
M
Michitaka
Kojiro
K
Minami
Hisaka
H
Murakami
Masato
M
Isobe
Yoshinori
Y
Horiike
Norio
N
Onji
Morikazu
M
D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006501:Hepatic Encephalopathy / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects*; D011172:Portography; D015642:Radiology, Interventional / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color