A 43-year-old woman with a huge portal-systemic shunt accompanied by myxedema showed slow speech and behavior. Several imaging studies revealed a bold portal-systemic shunt from the splenic vein to the left renal vein. In addition, hypothyroidism caused by chronic thyroiditis was diagnosed, and synthesized thyroxine replacement was effective for the symptoms. However, the serum ammonia and indo...

arterioportal fistula after blunt hepatic trauma: case reports.plications associated with the use of peritoneal drains in liver traumas. Mandatory laparotomy for gunshot wounds penetrating the abdomen. Am. Objective. Results ofthe first prospective randomized clinical trial comparing partial and total portacaval shunt for variceal hemorrhage are reported. Summary Background Data. Total portacav...

Hepatoportal sclerosis or idiopathic portal hypertension has a worldwide distribution with prevalence in developing and temperate countries. Of 64 patients with this disease seen during a twelve year period, 36 underwent splenectomy or a shunt procedure. The indications for surgical intervention were severe hypersplenism and persistent left upper abdominal pain andlorhistory of frequent ep...

BACKGROUND Transjugular intrahepatic porto-systemic shunt (TIPS) for Budd-Chiari syndrome (BCS) can be inserted from inferior vena cava or hepatic vein to portal vein. The former is performed when hepatic veins are not suitable and is technically more challenging. METHODS In this retrospective study, 7 patients with chronic BCS needed cavo-portal shunt as hepatic veins were neither amenable t...

In carefully selected patients with portosystemic encephalopathy, it is possible to safely disconnect the portal and systemic circulation while preserving the shunt. We report two patients with chronic hepatitis and recurrent episodes of hepatic encephalopathy due to a portosystemic shunt who underwent successful selective embolization of the splenic vein for a shunt-preserving disconnection of...

Upper gastrointestinal bleeding episodes from variceal structures are severe complications in patients with portal hypertension. Endoscopic sclerotherapy and variceal ligation are the treatment options preferred for upper variceal bleeding owing to extrahepatic portal hypertension due to portal vein thrombosis (PVT). Recurrent duodenal variceal bleeding in non-cirrhotic patients with diffuse po...

We report a case of recovered portal flow by ligation of the left renal vein on the first postoperative day after orthotopic liver transplantation of a 54-year-old female with alcoholic liver cirrhosis, chronic kidney failure, and spontaneous splenorenal shunt. After reperfusion, Doppler ultrasonography showed almost total diversion of the portal flow into the existing splenorenal shunt, but be...

This report presents the case of a 78-year-old female with hepatic encephalopathy due to an inferior mesenteric venous-inferior vena cava shunt. She developed hepatocellular carcinoma affected by hepatitis C virus-related cirrhosis and underwent posterior sectionectomy. Portal vein thrombosis developed and the portal trunk was narrowed after hepatectomy. Portal vein thrombosis resulted in high ...

A method is proposed to reduce portal hypertension utilizing subtotal splenectomy and a central splenorenal shunt. The advantages of this method are: diversion of the splenic component of the portal circulation, creation of a shunt for the portal blood into the systemic circulation, preservation of the splenic function and correction of the manifestations of the hypersplenism. Two cases are pre...