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Embolization of splenorenal shunt associated to portal vein thrombosis and hepatic encephalopathy.

World J Gastroenterol

November 2014

Letícia de Campos Franzoni, Fábio da Silva Yamashiro, Laís Augusti, Lívia Alves Amaral Santos, Mariana de Souza Dorna, Júlio Pinheiro Baima, Talles Bazeia Lima, Carlos Antonio Caramori, Giovanni Faria Silva, Fernando Gomes Romeiro, Internal Medicine Department, Gastroenterology Division, Botucatu Medical School, UNESP, 18 618 970 Botucatu, Sao Paulo, Brazil.

Unlabelled: Hepatic encephalopathy (HE) is a cognitive disturbance characterized by neuropsychiatric alterations. It occurs in acute and chronic hepatic disease and also in patients with portosystemic shunts. The presence of these portosystemic shunts allows the passage of nitrogenous substances from the intestines through systemic veins without liver depuration.

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A 57-year-old Japanese man was admitted to Toyama Medical & Pharmaceutical University Hospital with delirium and flapping tremor on April 2, 1997. He had been undergoing continuous ambulatory peritoneal dialysis (CAPD) because of diabetic nephropathy since 1993. Blood chemistry showed slightly elevated plasma ammonia level with no evidence of liver injury, and his portal venography revealed no port-systemic shunt.

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Objective: To report the case of a patient with bleeding oesophageal varices due to portal hypertension complicating hepatic sarcoidosis.

Patient: A 43-year-old man.

Methods: Six subsequent bleeds over 12 years were treated with sclerotherapy.

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