title: Intraperitoneal bleeding after balloon-occluded retrograde transvenous obliteration: a case report.
abstract: BACKGROUND
  Hepatic encephalopathy is an important underlying cause of consciousness disorders. Possible causes of hepatic encephalopathy include hepatic failure and shunt encephalopathy resulting from a portosystemic venous shunt. Balloon-occluded retrograde transvenous obliteration is generally an effective treatment for hepatic encephalopathy.
  
  
  METHODS
  A 73-year-old Japanese woman was referred to our department because of disturbance of consciousness. Hepatic venous angiography disclosed a shunt between her left hepatic vein and her portal vein. The shunt was closed with the use of coils and N-butyl 2-cyanoacrylate. One hour after the procedure, she lost consciousness. The bleeding was ascribed to catheter-induced vascular injury. Emergency angiography was performed, and hemostasis was achieved with coils.
  
  
  CONCLUSIONS
  Although bleeding is relatively rare after balloon-occluded retrograde transvenous obliteration, postoperative intraperitoneal bleeding is a serious complication.
authors.affiliation: Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan. no.alternative.to.me@gmail.com.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Furue
authors.affiliation: Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan. hisashi7@kitasato-u.ac.jp.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Hidaka
authors.affiliation: Department of Diagnostic Radiology, Kitasato University School of Medicine, Sagamihara, Japan. kaorufujii33@yahoo.co.jp.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Department of Diagnostic Radiology, Kitasato University School of Medicine, Sagamihara, Japan. kgmatsu@kitasato-u.ac.jp.
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsunaga
authors.affiliation: Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan. koizumi@med.kitasato-u.ac.jp.
authors.forename: Wasaburo
authors.initials: W
authors.lastname: Koizumi
mesh_terms: D000368:Aged; D000792:Angiography; D021721:Balloon Occlusion / Q000009:adverse effects* / Q000379:methods; D003244:Consciousness Disorders / Q000209:etiology; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006501:Hepatic Encephalopathy / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006503:Hepatic Veins / Q000002:abnormalities; D006801:Humans; D011169:Portal Vein / Q000002:abnormalities; D012187:Retroperitoneal Space; D014057:Tomography, X-Ray Computed