Portal-Systemic Shunt between the Inferior Mesenteric Vein and Inferior Vena Cava in a Patient with Hepatic Encephalopathy : Successful Occlusion by Balloon-Occluded Retrograde Transvenous Obliteration

Kakizawa Hideaki

Toyota Naoyuki

Hieda Masashi

Ishikawa Masaki

Tanitame Keizo

Tani Chihiro

Okazaki Akihito

Takaki Shintaro

Aikata Hiroshi

Chayama Kazuaki

Awai Kazuo

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

A large shunt between the inferior mesenteric vein (IMV) and the inferior vena cava (IVC) is a rare type of portosystemic shunt in patients with hepatic encephalopathy. We report a patient with hepatic encephalopathy due to a large IMV-IVC shunt who was successfully treated by balloon-occluded retrograde transvenous obliteration. The procedure involved a combination of 11 metallic coils and 5 ml of 5% ethanolamine oleate with iopamidol as the sclerosing agent. After complete obliteration of the shunt, his symptoms disappeared. At 2-years follow-up he was free of clinical symptoms, the size of his liver had slightly increased, and his liver function was preserved.

BRTO

Hepatic encephalopathy

Portal-systemic shunt

Medical sciences [ 490 ]

eng

Hiroshima University Medical Press

(c) Hiroshima University Medical Press.

[ISSN] 0018-2052

[NCID] AA00664312