バルーン下逆行性経静脈的塞栓術(B-RTO)により軽快した下腸間膜静脈-右内腸骨静脈短絡路による脳症の1例  [in Japanese] A case of portal-systemic shunt-through inferior mesenteric vein and right internal iliac vein-encephalopathy cured by balloon-occluded retrograde transvenous obliteration  [in Japanese]

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Abstract

症例は73歳,男性.主訴は意識障害.血中アンモニア濃度が上昇(156 μg/d<i>l</i>)していたが慢性肝疾患はなく,腹部造影CTにて下腸間膜静脈∼右内腸骨静脈に短絡路を認めた.同短絡路による脳症はまれであり,本例は右内腸骨静脈経由でバルーン下逆行性経静脈的塞栓術(B-RTO)を行った最初の症例であるが,治療から5年経過後も再発は認めていない.<br>

We encountered a case of portal-systemic shunt encephalopathy cured by balloon-occluded retrograde transvenous obliteration (B-RTO). A 73-year-old man had been observed for membranous nephropathy at our hospital since 1987. There was no past history of liver dysfunction. He was admitted with encephalopathy. Abdominal enhanced computed tomography showed a portosystemic shunt through the inferior mesenteric vein and right internal iliac vein. We diagnosed hepatic encephalopathy due to this porto-systemic shunt, and B-RTO was performed. After B-RTO, he has not had repeated encephalopathy. B-RTO can be effective for portosystemic encephalopathy. Inferior mesenteric-right internal iliac shunt encephalopathy is rare and our patient is the first case of B-RTO performed in cases with this shunt.<br>

Journal

  • Nippon Shokakibyo Gakkai Zasshi

    Nippon Shokakibyo Gakkai Zasshi 106(12), 1764-1769, 2009-12-05

    The Japanese Society of Gastroenterology

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