Chronic portosystemic encephalopathy: embolization of portosystemic shunts.

Abstract:

:Operative ligation of portosystemic shunts is effective in controlling chronic portosystemic encephalopathy (CPSE) but is associated with significant mortality. Review of the records of five patients with CPSE treated with radiologic occlusion procedures showed that these are suitable alternatives to surgery. Three patients had alcoholic cirrhosis, one had hepatic fibrosis from schistosomiasis, and one had post-necrotic cirrhosis. All had CPSE with progressive, severe cerebral impairment refractory to clinical treatment. Four patients had a spontaneous splenorenal shunt, and one had a surgically created mesocaval shunt (MCS). Partial splenic embolization was performed in two patients, direct shunt embolization was performed via percutaneous transhepatic portography in two other patients, and an MCS embolization was performed in one patient through the inferior vena cava. In four patients embolization controlled the CPSE. In the remaining patient it could not be evaluated because of his premature death from intraabdominal bleeding, a late complication of the procedure. Interventional radiologic procedures are effective in the control of CPSE in selected patients.

journal_name

Radiology

journal_title

Radiology

authors

Uflacker R,Silva Ade O,d'Albuquerque LA,Piske RL,Mourão GS

doi

10.1148/radiology.165.3.3685350

subject

Has Abstract

pub_date

1987-12-01 00:00:00

pages

721-5

issue

3

eissn

0033-8419

issn

1527-1315

journal_volume

165

pub_type

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