Post-TIPS hepatic encephalopathy treated by occlusion balloon-assisted retrograde embolization of a coexisting spontaneous splenorenal shunt |
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| Authors: | Yasukazu Shioyama MD Kiyoshi Matsueda Koushi Horihata Masashi Kimura Norifumi Nishida Kazushi Kishi Masaki Terada Morio Sato Ryusaku Yamada |
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| Institution: | (1) Department of Radiology, The Central Hospital and Cancer Center of Ibaraki Prefecture, 6528 Koibuchi Tomobe-machi, 309-17 Nishiibaraki-gun Ibaraki, Japan;(2) Department of Radiology, Wakayama Medical College, 27 7-bancho, 640 Wakayama-shi, Wakayama, Japan |
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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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| Keywords: | Esophageal varices Portal hypertension Transjugular intrahepatic portosystemic shunt Balloonoccluded retrograde transvenous obliteration Hepatic encephalopathy |
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