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- Title
CASE REPORT: Intrahepatic portal-hepatic venous shunts associated with a huge pelvic leiomyoma.
- Authors
AIBA, NOBUYASU; MORIOKA, JUNICHIRO; MIYAZONO, TAKAYOSHI; OKITA, HIDEAKI; YATA, YUTAKA; OKADA, KAZUHIKO; NAMBU, SHUJI; WATANABE, AKIHARU; SHIMIZU, MASASHI; FUJIMURA, MASAKI; IZUMI, RIKUICHI
- Abstract
ABSTRACT We present a case of portal-systemic encephalopathy due to intrahepatic multiple portalhepatic venous shunts. A 71-year-old woman was admitted to our hospital because of recurrent episodes of disturbed consciousness. She showed no clinical signs of portal hypertension. Liver function was normal, except for an indocyanine green retention rate of 34% at 15 min and blood ammonia level of 282 μg/dL. Portal venography revealed dilatation of the portal vein and multiple portal-hepatic venous shunts, and a liver biopsy specimen revealed almost normal liver. Further clinical examination revealed a huge pelvic tumour. At laparotomy, two dilated veins were seen to arise from the pelvic tumour with blood flow into the mesentery. The tumour was resected successfully and a histological diagnosis of leiomyoma was made. The blood ammonia concentration decreased to the normal range postoperatively. A follow-up portal venogram demonstrated decreased portal vein dilatation and minor portalhepatic venous shunts, considered to be congenital in origin. It is concluded that liepatic encephalopathy was produced in this patient due to an excess portal blood flow from the huge pelvic leiomyoma via the mesentery, with portosystemic shunting through pre-existent (probably congenital) intrahepatic anastomoses.
- Publication
Journal of Gastroenterology & Hepatology, 1998, Vol 13, Issue 2, p158
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/j.1440-1746.1998.tb00631.x