[Portal vein thrombosis associated with hepatic encephalopathy].
A 54-year-old man who had been administered chlormadinone acetate 3 months after prostatectomy for prostate cancer, acutely developed disorientation and memory disturbance. Six days later, he experienced high grade fever and epigastralgia. He was suspected to have hepatic encephalopathy, because the Fischer ratio was low although serum ammonia level remained normal. Further examinations including abdominal echography and CT scan disclosed a thrombus extending from the portal vein to the superior mesenteric vein together with abnormal collateral vessels originating from the portal vein. He was successfully treated with warfarin potassium, urokinase and heparin sodium. It was suggested that the patient developed hepatic encephalopathy due to portal-systemic circulation shunting secondary to portal vein thrombosis.
Iwatani
Nao
N
Stroke Center, Saiseikai Kumamoto Hospital.
Inatomi
Yuichiro
Y
Yonehara
Toshiro
T
Fujioka
Shodo
S
Hashimoto
Yoichiro
Y
Hirano
Teruyuki
T
Uchino
Makoto
M
D004359:Drug Therapy, Combination; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006493:Heparin / Q000008:administration & dosage; D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage; D020246:Venous Thrombosis / Q000150:complications* / Q000188:drug therapy; D014859:Warfarin / Q000008:administration & dosage
D005343:Fibrinolytic Agents; D014859:Warfarin; D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator