Intractable Hepatic Encephalopathy with a Large Portosystemic Shunt Successfully Treated Using Shunt-preserving Disconnection of the Portal and Systemic Circulation

Hepatic encephalopathy (HE) is a significant symptom of decompensated liver cirrhosis. Occlusion of portosystemic shunts is used to treat refractory HE. Nevertheless, these treatments often cause adverse events, such as ascites and esophageal varices. We treated a 57-year-old man with refractory HE...

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Autores principales: Haraguchi, Masafumi, Hirai, Satoshi, Nakamura, Yutaka, Otsuka, Tetsuhiro, Ishimaru, Hideki, Sasaki, Ryu, Fukushima, Masanori, Miuma, Satoshi, Miyaaki, Hisamitsu, Nakao, Kazuhiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2020
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205523/
https://www.ncbi.nlm.nih.gov/pubmed/32009096
http://dx.doi.org/10.2169/internalmedicine.3955-19
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author Haraguchi, Masafumi
Hirai, Satoshi
Nakamura, Yutaka
Otsuka, Tetsuhiro
Ishimaru, Hideki
Sasaki, Ryu
Fukushima, Masanori
Miuma, Satoshi
Miyaaki, Hisamitsu
Nakao, Kazuhiko
author_facet Haraguchi, Masafumi
Hirai, Satoshi
Nakamura, Yutaka
Otsuka, Tetsuhiro
Ishimaru, Hideki
Sasaki, Ryu
Fukushima, Masanori
Miuma, Satoshi
Miyaaki, Hisamitsu
Nakao, Kazuhiko
author_sort Haraguchi, Masafumi
collection PubMed
description Hepatic encephalopathy (HE) is a significant symptom of decompensated liver cirrhosis. Occlusion of portosystemic shunts is used to treat refractory HE. Nevertheless, these treatments often cause adverse events, such as ascites and esophageal varices. We treated a 57-year-old man with refractory HE using shunt-preserving disconnection of the portal and systemic circulation (SPDPS). After SPDPS, there were no obvious complications, and the patient's ammonia level significantly decreased. To date, the patient has not experienced recurrent HE. SPDPS appears to be a safe and effective treatment method for portosystemic encephalopathy.
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spelling pubmed-72055232020-05-12 Intractable Hepatic Encephalopathy with a Large Portosystemic Shunt Successfully Treated Using Shunt-preserving Disconnection of the Portal and Systemic Circulation Haraguchi, Masafumi Hirai, Satoshi Nakamura, Yutaka Otsuka, Tetsuhiro Ishimaru, Hideki Sasaki, Ryu Fukushima, Masanori Miuma, Satoshi Miyaaki, Hisamitsu Nakao, Kazuhiko Intern Med Case Report Hepatic encephalopathy (HE) is a significant symptom of decompensated liver cirrhosis. Occlusion of portosystemic shunts is used to treat refractory HE. Nevertheless, these treatments often cause adverse events, such as ascites and esophageal varices. We treated a 57-year-old man with refractory HE using shunt-preserving disconnection of the portal and systemic circulation (SPDPS). After SPDPS, there were no obvious complications, and the patient's ammonia level significantly decreased. To date, the patient has not experienced recurrent HE. SPDPS appears to be a safe and effective treatment method for portosystemic encephalopathy. The Japanese Society of Internal Medicine 2020-02-01 2020-04-15 /pmc/articles/PMC7205523/ /pubmed/32009096 http://dx.doi.org/10.2169/internalmedicine.3955-19 Text en Copyright © 2020 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Haraguchi, Masafumi
Hirai, Satoshi
Nakamura, Yutaka
Otsuka, Tetsuhiro
Ishimaru, Hideki
Sasaki, Ryu
Fukushima, Masanori
Miuma, Satoshi
Miyaaki, Hisamitsu
Nakao, Kazuhiko
Intractable Hepatic Encephalopathy with a Large Portosystemic Shunt Successfully Treated Using Shunt-preserving Disconnection of the Portal and Systemic Circulation
title Intractable Hepatic Encephalopathy with a Large Portosystemic Shunt Successfully Treated Using Shunt-preserving Disconnection of the Portal and Systemic Circulation
title_full Intractable Hepatic Encephalopathy with a Large Portosystemic Shunt Successfully Treated Using Shunt-preserving Disconnection of the Portal and Systemic Circulation
title_fullStr Intractable Hepatic Encephalopathy with a Large Portosystemic Shunt Successfully Treated Using Shunt-preserving Disconnection of the Portal and Systemic Circulation
title_full_unstemmed Intractable Hepatic Encephalopathy with a Large Portosystemic Shunt Successfully Treated Using Shunt-preserving Disconnection of the Portal and Systemic Circulation
title_short Intractable Hepatic Encephalopathy with a Large Portosystemic Shunt Successfully Treated Using Shunt-preserving Disconnection of the Portal and Systemic Circulation
title_sort intractable hepatic encephalopathy with a large portosystemic shunt successfully treated using shunt-preserving disconnection of the portal and systemic circulation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205523/
https://www.ncbi.nlm.nih.gov/pubmed/32009096
http://dx.doi.org/10.2169/internalmedicine.3955-19
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