title: Congenital portal systemic encephalopathy misdiagnosed as senile dementia.
abstract: Congenital portal systemic encephalopathy without liver cirrhosis and/or portal hypertension is rare. An 86-year-old man with senile dementia was admitted due to disturbance of consciousness. His serum ammonia level was high, but there was no evidence of liver cirrhosis or portal hypertension on laboratory tests and upper abdominal enhanced computed tomography (CT). However, on lower abdominal enhanced CT, a meso-caval shunt was found in the right lower abdomen. Superior mesenteric arteriography revealed a shunt flowing into the inferior vena cava via the right gonadal vein. The shunt was closed by balloon occluded retrograde transvenous obliteration, and dementia-like symptoms improved.
authors.affiliation: Department of Internal Medicine, Naga Municipal Hospital, Kinokawa.
authors.forename: Kaori
authors.initials: K
authors.lastname: Miyata
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Tamai
authors.forename: Akiko
authors.initials: A
authors.lastname: Uno
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Nakao
authors.forename: Tokuro
authors.initials: T
authors.lastname: Muroki
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Nasu
authors.forename: Akira
authors.initials: A
authors.lastname: Kawashima
authors.forename: Taisei
authors.initials: T
authors.lastname: Nakao
authors.forename: Michi
authors.initials: M
authors.lastname: Kondo
authors.forename: Masao
authors.initials: M
authors.lastname: Ichinose
mesh_terms: D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood / Q000175:diagnosis*; D000641:Ammonia / Q000097:blood; D000792:Angiography; D003951:Diagnostic Errors; D006501:Hepatic Encephalopathy / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008643:Mesentery / Q000098:blood supply; D011860:Radiography, Abdominal
chemical_list: D000641:Ammonia