title: Portal-systemic shunt between the inferior mesenteric vein and inferior vena cava in a patient with hepatic encephalopathy: successful occlusion by balloon-occluded retrograde transvenous obliteration.
abstract: A large shunt between the inferior mesenteric vein (IMV) and the inferior vena cava (IVC) is a rare type of portosystemic shunt in patients with hepatic encephalopathy. We report a patient with hepatic encephalopathy due to a large IMV-IVC shunt who was successfully treated by balloon-occluded retrograde transvenous obliteration. The procedure involved a combination of 11 metallic coils and 5 ml of 5% ethanolamine oleate with iopamidol as the sclerosing agent. After complete obliteration of the shunt, his symptoms disappeared. At 2-years follow-up he was free of clinical symptoms, the size of his liver had slightly increased, and his liver function was preserved.
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan. kakizawa@hiroshima-u.ac.jp
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kakizawa
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Toyota
authors.forename: Masashi
authors.initials: M
authors.lastname: Hieda
authors.forename: Masaki
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Keizo
authors.initials: K
authors.lastname: Tanitame
authors.forename: Chihiro
authors.initials: C
authors.lastname: Tani
authors.forename: Akihito
authors.initials: A
authors.lastname: Okazaki
authors.forename: Shintaro
authors.initials: S
authors.lastname: Takaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
mesh_terms: D000368:Aged; D021721:Balloon Occlusion / Q000379:methods*; D006501:Hepatic Encephalopathy / Q000628:therapy*; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000002:abnormalities*; D014682:Vena Cava, Inferior / Q000002:abnormalities*