[A case of hepatic encephalopathy successfully treated by antegrade glycerin enema through percutaneous endoscopic cecostomy].
A 76-year-old man with liver cirrhosis, a chronic defecation disorder and a refractory hepatic encephalopathy was hospitalized for the hepatic encephalopathy. The encephalopathy quickly improved upon treatment, but a high level of serum ammonia persisted. We inserted a percutaneous endoscopic cecostomy at the cecum and an antegrade glycerin enema through it to treat the chronic defecation disorder, which was a deteriorative factor of the hepatic encephalopathy. After the aforementioned procedure, the chronic defecation disorder improved and the serum ammonia level dramatically decreased. The patient continued the antegrade glycerin enema at home, and serum ammonia values remained low in comparison to levels measured prior to the administration of treatment. The subject has not experienced a recurrence of hepatic encephalopathy.
Tomikashi
Koichi
K
Digestive Disease Center, Kohoku General Hospital.
Nomura
Yuh
Y
Miyawaki
Kiichiro
K
Shimada
Ayumi
A
Kanemitsu
Daisuke
D
Takashima
Hidetaka
H
Abe
Mitsumasa
M
D000368:Aged; D000641:Ammonia / Q000097:blood; D002431:Cecostomy / Q000379:methods*; D003248:Constipation / Q000150:complications / Q000628:therapy; D016099:Endoscopy, Gastrointestinal; D004733:Enema; D005990:Glycerol / Q000008:administration & dosage*; D006501:Hepatic Encephalopathy / Q000628:therapy*; D006801:Humans; D008297:Male
D000641:Ammonia; D005990:Glycerol