Gastrorenal shunts may induce hyperammonemia. Portosystemic shunts should be suspected when hyperammonemia occurs in patients with chronic kidney disease.

We present the case of a recurrent hyperammonaemic encephalopathy due to a portosystemic shunt that was successfully treated by embolization.

Examination of a 2-month-old male golden retriever presented to the hospital revealed malnutrition, ascites, cardiac murmur and hyperammonemia. Identification of subaortic stenosis and hepatic arteriovenous fistula was made through ultrasonography and angiocardiography. In addition, intrasurgical mesenteric portography showed an intrahepatic portosystemic shunt. The dog did not show portal hype...

Pulmonary gas exchange abnormalities and refractory hypoxemia cause myriad difficulties in patients with chronic liver disease. In addition to intrinsic cardiopulmonary diseases and hepatopulmonary syndrome, some unusual pathophysiological mechanisms in patients with portosystemic collaterals might contribute to hypoxemia. We report the clinical presentation of an unusual portosystemic anatomic...

Aneurysmal portohepatic venous shunt is communication between the branches of portal and hepatic veins that shows aneurysmal dilatation. They are rare. However with advances in cross-sectional imaging techniques and increased utilization of imaging modalities, the detection of asymptomatic intrahepatic portosystemic venous shunts has increased. Identification and characterization of the portosy...

Hepatic encephalopathy (HE) is a syndrome of neuropsychiatric dysfunction caused by portosystemic venous shunting, with or without intrinsic liver disease. Patients with hepatic encephalopathy often present with the onset of mental status changes ranging from subtle psychologic abnormalities to profound coma. Several hypotheses have been proposed to explain the mental impairment associated with...

64 Hepatic encephalopathy (HE) or Portosystemic encephalopathy (PSE) in end-stage liver disease (ESLD) such as cirrhosis of the liver is a reversible and recurrent disorder of neurological function caused by liver disease or portosystemic shunting of blood or both. In this article only hepatic encephalopathy (HE) in chronic end-stage liver disease (ESLD) will be discussed. Hepatic encephalopath...

Gastrointestinal (GI) bleeding is a common complication of cirrhosis and portal hypertension. Most cases are secondary to gastro-esophageal variceal rupture, managed endoscopically1. Stomal rare there’s no standard therapy2. We present case cirrhotic patient with recurrent stomal hemorrhage successfully treated transjugular intrahepatic portosystemic shunt (TIPS) varices embolization.

The Budd-Chiari syndrome is a heterogeneous group of disorders characterized by obstruction of hepatic venous outflow at any level from the small hepatic veins to the junction of the inferior vena cava with the right atrium. We present two cases of Budd- Chiari syndrome with severe ascites associated with polycythemia vera in first case and protein C deficiency in the second, in both cases tran...

Editor, We read with interest the article by Niessen et al. (1) entitled “Irreversible Electroporation of a Hepatocellular Carcinoma Lesion Adjacent to a Transjugular Intrahepatic Portosystemic Shunt Stent Graft”. In the article, the authors detailed the use of irreversible electroporation in the treatment of a hepatocellular carcinoma (HCC) adjacent to a transjugular intrahepatic portosystemic...