Non-cirrhotic portal-systemic encephalopathy caused by enlargement of a splenorenal shunt after pancreaticoduodenectomy for locally advanced duodenal cancer: Report of a case

Yuta Kasagi, Hiroshi Saeki, Tomohiko Akahoshi, Junji Kawasaki, Koji Ando, Eiji Oki, Takefumi Ohga, Morimasa Tomikawa, Yoshihiro Kakeji, Ken Shirabe, Yoshihiko Maehara

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Abstract

We report a case of portal-systemic encephalopathy occurring secondary to a splenorenal shunt, 2 years after a pancreaticoduodenectomy for locally advanced duodenal carcinoma. A 55-year-old woman was brought to our hospital with a decreased level of consciousness. Laboratory testing revealed an elevated serum ammonia level (221 μg/dl) and normal liver function. Retrospective review of a series of contrast-enhanced computed tomography scans of the abdomen identified a splenorenal shunt, which had gradually enlarged over the past 2 years (Fig. 1). The decreased level of consciousness was thought to be due to portal-systemic encephalopathy secondary to the splenorenal shunt. We performed balloon-occluded retrograde transvenous obliteration to occlude the splenorenal shunt, following which her serum ammonia level returned to normal (28 μg/dl) and an alert level of consciousness was maintained.

Original languageEnglish
Pages (from-to)1573-1576
Number of pages4
JournalSurgery today
Volume44
Issue number8
DOIs
Publication statusPublished - Aug 2014

All Science Journal Classification (ASJC) codes

  • Surgery

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