Background: The prognostic role of spontaneous portosystemic shunts (SPSS) has been poorly investigated.
Aims: To evaluate the impact of the presence of SPSS, as well as their characteristics, on the risk of decompensation.
Methods: This is a retrospective cohort study of 235 advanced chronic liver disease (ACLD) patients with available imaging examination, transient elastography, and upper endoscopy. ACLD was defined as liver stiffness measurement (LSM) >10 kPa. Competitive risk analyses were performed to identify the factors associated with the main outcome.
Results: SPSS were reported in 141 (60%) of the patients. Non-viral etiology was independently associated with SPSS presence [Odds-Ratio (OR): 2.743;95%-Interval-of-Confidence (IC):1.129-6.664]. During a follow-up of 37 (20-63) months, SPSS were found predictors of any decompensation type [Subhazard Ratio (SHR):2.264; 95%-IC:1.259-4.071], independently from a history of decompensation or high-risk-varices presence. The risk of complications was higher in patients with large (SHR: 3.775; 95%-IC: 2.016-7.070) and multiple (SHR:3.832; 95%-IC: 2.004-7.330) shunts, and in those with gastrorenal shunts (SHR:2.636; 95%-IC:1.521-4.569).
Conclusions: The presence, size, and number of SPSS predict not only the risk of hepatic encephalopathy but that of any type of decompensation across all stages of cirrhosis. Future studies should explore the possibility of treating shunts to prevent decompensation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.dld.2020.12.114 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Intrahepatic portosystemic shunt: salvage mechanism for oligohydramnios complicating fetal growth restriction.
Ultrasound Obstet Gynecol
January 2025
Ultrasound Unit, Helen Schneider Hospital for Women, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
Objective: Portosystemic shunts in growth-restricted fetuses are more common than previously thought. We aimed to describe fetuses with growth restriction and transient oligohydramnios in which a congenital intrahepatic portosystemic shunt (CIPSS) was noted during follow-up.
Methods: This was a retrospective study of all fetuses diagnosed with growth restriction and transient oligohydramnios during a 5-year period in a large tertiary referral center.
Introduction Fetal extrahepatic portosystemic Venous Shunt (FEPSVS) are vascular malformations that divert placental and bowel blood from the liver into the systemic circulation. When uncorrected, it can lead to severe pathologic consequences after birth. Objective To report our method of prenatal diagnosis, the developing insight regarding prenatal counseling, and postnatal treatment.
View Article and Find Full Text PDFHepatic encephalopathy in non-cirrhotic portal hypertension.
Metab Brain Dis
January 2025
Institute of Liver and Biliary Sciences, New Delhi, India.
Hepatic encephalopathy (HE) is traditionally associated with hepatic parenchymal diseases, such as acute liver failure and cirrhosis. Its prevalence in non-cirrhotic portal hypertension (NCPH) patients, extrahepatic portal vein obstruction (EHPVO), and non-cirrhotic portal fibrosis (NCPF) is less well described. HE in NCPH allows one to study the effect of portosystemic shunting and ammonia without significant hepatic parenchymal injury.
View Article and Find Full Text PDFSuccessful portosystemic shunt embolization resolves hepatic encephalopathy and enhances hepatic function and glycemic control in MASH-related cirrhosis: a case report.
Clin J Gastroenterol
December 2024
Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
We report the case of a 70-year-old woman with advanced hepatic encephalopathy (HE) secondary to metabolic dysfunction-associated steatohepatitis (MASH)-related cirrhosis who exhibited an excellent response to portosystemic shunt embolization. Four years earlier, she was diagnosed as having MASH-related cirrhosis accompanied by multiple mesenteric vein-inferior vena cava shunts. As her condition progressed, she suffered recurrent HE that was unresponsive to oral medication, prompting the decision to proceed with shunt embolization.
View Article and Find Full Text PDFCongenital intrahepatic portosystemic shunt in 27 children: an experience and treatment strategy of a single centre in China.
Front Pediatr
November 2024
Department of General Surgery, Capital Institute of Pediatrics, Beijing, China.
Objective: To evaluate treatment strategies for congenital intrahepatic portosystemic shunt (CIPSS) based on the experience of treating 27 children.
Methods: Between August 2017 and January 2024, our team treated 27 children with CIPSS. Twelve patients underwent surgical ligation of the portosystemic shunt, while 15 patients diagnosed prenatally received conservative treatment without surgery.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!