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Post-TIPS hepatic encephalopathy treated by occlusion balloon-assisted retrograde embolization of a coexisting spontaneous splenorenal shunt

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Abstract

A 51-year-old man with posthepatitis cirrhosis underwent a transjugular intrahepatic portosystemic shunt (TIPS) for bleeding of recurrent esophageal varices. The patient had a coexisting, spontaneous, splenorenal shunt. He subsequently developed hepatic encephalopathy, presumably due to excessive portosystemic shunting. Since medical management resulted in no significant improvement, the splenorenal shunt was embolized from the jugular vein approach via renal vein access during temporary balloon occlusion. Within a few days, the patient's hepatic encephalopathy resolved. Twelve months later the patient showed no recurrence of encephalopathy and had maintained a patent TIPS.

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References

  1. Widrich WC, Srinivasan M, Semine MC, Robbins AH (1984) Collateral pathways of the left gastric vein in portal hypertension. AJR 142: 375–382

    PubMed  CAS  Google Scholar 

  2. Olson, E, Yune HY, Klatte EC (1984) Transrenal-vein reflux ethanol sclerosis of gastroesophageal varices. AJR 143: 627–628

    PubMed  CAS  Google Scholar 

  3. Kanekawa H, Mima T, Kayama A (1991) Treatment of gastric varix by balloon-occluded retrograde transvenous obliteration (B-RTO). Acta Hepat Jap 32: 442

    Google Scholar 

  4. Rosch J., Hanafee WN, Snow H (1969) Work in progress. Transjugular portal venography and radiological portacaval shunt: An experimental study. Radiology 92: 1112–1114

    PubMed  CAS  Google Scholar 

  5. Richter GM, Palmaz JC, Noldge G, Rossle M, Siegerstetter V, Franke M, Wenz W (1989) Der Transjugulare intrahepatische portosystemische stent-shunt (TIPSS), Radiologie 29: 406–410

    CAS  Google Scholar 

  6. Freedman AM, Sanyal AJ, Tisnado J, Cole PE, Shiffman ML, Luketic VA, Purdum PP, Darcy MD, Posner MP (1993) Complications of transjugular intrahepatic portosystemic shunt: A comprehensive review. Radiographics 13: 1185–1210

    PubMed  CAS  Google Scholar 

  7. LaBerge JM, Ring EJ, Gordon RL, Lake JR, Doherty MM, Somberg KA, Roberts JP, Ascher NL (1993) Creation of transjugular intrahepatic portosystemic shunts with the Wallstent endoprosthesis: Results in 100 patients. Radiology 187: 413–420

    PubMed  CAS  Google Scholar 

  8. Takase Y, Shibuya S, Chikamori F (1990) Recurrence factors studied by percutaneous transhepatic portography before and after endoscopic sclerotherapy for esophageal varices. Hepatology 11: 348–352

    PubMed  CAS  Google Scholar 

  9. Ikeda N, Ito T, Takabatake H, Tsuji T, Watanabe M (1990) A case of non-cirrhotic portal hematogenous abnormality. Nippon Naika Gakkai Zasshi 79: 1081–1082

    PubMed  CAS  Google Scholar 

  10. Shioyama Y, Yamada R (1993) Interventional radiology, mainly TIPS. Med Imagings 13: 1383–1391

    Google Scholar 

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Shioyama, Y., Matsueda, K., Horihata, K. et al. Post-TIPS hepatic encephalopathy treated by occlusion balloon-assisted retrograde embolization of a coexisting spontaneous splenorenal shunt. Cardiovasc Intervent Radiol 19, 53–55 (1996). https://doi.org/10.1007/BF02560150

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