Successful Surgical Treatment for Inose-type Hepatic Encephalopathy caused by the Porto-systemic Shunt Via Superior Mesenteric Varices: A Case Report

• Mizuno Takashi

  First Department of Surgery, Nara Medical University

• Ko Saiho

  First Department of Surgery, Nara Medical University

• Kobayashi Toyoki

  First Department of Surgery, Nara Medical University

• Kanokogi Hideki

  First Department of Surgery, Nara Medical University

• Nakajima Yoshiyuki

  First Department of Surgery, Nara Medical University

Bibliographic Information

Other Title

• 上腸間膜静脈瘤を介した門脈-大静脈シャントの外科的遮断により軽快した猪瀬型肝性脳症の1例

Abstract

A 78-year-old woman with chronic hepatitis type B who had often gone into a coma of unknown origin since August 1986 was examined in 1999 and found to have high blood NH₃->200μg/dl-and superior mesenteric varices with a diameter of 2 cm. Portal phase of mesenteric arteriography showed a massive portosystemic shunt from the ileocecal vein to the vena cava via the varices. She was diagnosed with Inose hepatic encephalopathy and underwent surgery to close the shunt. After confirming that portal venous pressure was less than 180 mmH₂O by test clamping of the shunt, varices were resected. Pulsed Doppler ultrasonography showed a significant increase in portal blood inflow to the liver and blood NH₃ decreased to 50μg/dl immediately after surgery. Her encephalopathy disappeared completely and she remains healthy with improved liver functional reserve to date.

Journal

• The Japanese Journal of Gastroenterological Surgery

  The Japanese Journal of Gastroenterological Surgery 35 (2), 161-165, 2002

  The Japanese Society of Gastroenterological Surgery

Keywords

• Gastroenterology
• Surgery

Details

• CRID: 1390001204915858688
• NII Article ID: 130004343680
• NII Article ID: 110001344170
• NII Book ID: AN00192066
• DOI: 10.5833/jjgs.35.161
• ISSN: 13489372
• ISSN: 03869768
• Web Site: https://www.jstage.jst.go.jp/article/jjgs1969/35/2/35_2_161/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2002146934
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed