title: Successful portal-systemic shunt occlusion with balloon-occluded retrograde transvenous obliteration for portosystemic encephalopathy without liver cirrhosis.
abstract: A 68-year-old woman was admitted to the authors' hospital for hepatic encephalopathy. Her laboratory data and computed tomography findings were not suggestive of liver cirrhosis. Superior mesenteric angiography revealed an extrahepatic portal-systemic shunt with a main cause of hepatic encephalopathy. Despite treatment with branched-chain amino acid, lactulose, and kanamycin, hyperammonemia was prolonged, and the portal-systemic shunt was therefore treated with balloon-occluded retrograde transvenous obliteration. After the procedure, hyperammonemia was improved, and there were no signs of recurrent portal-systemic encephalopathy.
authors.affiliation: Department of Radiology, Yamashiro Public Hospital, and Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. otanaka@bf7.so-net.ne.jp
authors.forename: Osamu
authors.initials: O
authors.lastname: Tanaka
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ishihara
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Oyamada
authors.forename: Akihito
authors.initials: A
authors.lastname: Harusato
authors.forename: Taiji
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Masaru
authors.initials: M
authors.lastname: Ozawa
authors.forename: Koji
authors.initials: K
authors.lastname: Nakano
authors.forename: Takuji
authors.initials: T
authors.lastname: Yamagami
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
mesh_terms: D000368:Aged; D000792:Angiography; D021721:Balloon Occlusion / Q000379:methods*; D005260:Female; D006501:Hepatic Encephalopathy / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D022124:Hyperammonemia / Q000209:etiology; D014057:Tomography, X-Ray Computed