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...

INTRODUCTION Portosystemic shunts are anomalous vessels that join the portal and systemic venous circulation, allowing most of the portal blood to bypass the liver and enter the systemic circulation and are classified as intrahepatic or extrahepatic. Portosystemic shunting occurs either as a single congenital shunt or as multiple acquired shunts due to chronic portal hypertension. Radiographic ...

Hepatic encephalopathy (HE) remains a diagnosis of exclusion due to the lack of specific signs and symptoms. Refractory HE is an uncommon but serious condition that requires the search of hidden precipitating events (i.e., portosystemic shunt) and alternative diagnosis. Hypothyroidism shares clinical manifestations with HE and is usually considered within the differential diagnosis of HE. Here,...

PURPOSE We assessed whether magnetic resonance (MR) imaging evaluation of portosystemic collateral shunts can aid prediction of therapeutic effectiveness and complications after creation of a transjugular portosystemic shunt (TIPS), and technical difficulty during the TIPS procedure. MATERIALS AND METHODS We retrospectively reviewed 32 patients (27 men, 5 women; mean age, 56.4 years) who unde...

BACKGROUND Portal hypertension leads to the formation of portosystemic collateral veins in liver cirrhosis. The resulting shunting is responsible for the development of portosystemic encephalopathy. Although ammonia plays a certain role in determining portosystemic encephalopathy, the venous ammonia level has not been found to correlate with the presence or severity of this entity. So, it has b...

INTRODUCTION Recent data suggest that mucosal abnormalities can occur even in the duodenum, jejunum, and distal ileum of cirrhosis patients. We present a case of portal hypertensive enteropathy in a cirrhosis patient shown by capsule endoscopy and the effect of transjugular intrahepatic portosystemic shunt on the ileal pictures. CASE PRESENTATION An 83-year-old Caucasian woman was admitted to...

AIMS This study aimed at assessing the risk factors for hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) in patients with hepatocellular carcinoma (HCC) and portal hypertension. METHOD Consecutive patients (n=279) with primary HCC who underwent TIPS between January 1997 and March 2012 at a single institution were retrospectively reviewed. Patients were fo...

background the transjugular intrahepatic portosystemic stent-shunt (tipss) builds a shortcut between the portal vein and a liver vein, and represents a sophisticated alternative to open surgery in the management of portal hypertension or its complications. objectives to describe clinical experiences with a low-profile nitinol stent system in tipss creation, and to assess primary and long-term s...