Clinical investigation in non-liver cirrhosis portosystemic shunt encephalopathy—four case series—
We reported here four cases presenting with disturbance of consciousness over long periods of time and hyperammonemia. Two patients were on maintenance hemodialysis. Contrast-enhanced computed tomography (CT) of abdomen and balloon-occluded retrograde contrast venography revealed existence of a non-...
Guardado en:
| Autores principales: | , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Fujita Medical Society
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/39119421d4a74ae18d696b34ce541001 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:39119421d4a74ae18d696b34ce541001 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:39119421d4a74ae18d696b34ce5410012021-11-10T04:40:26ZClinical investigation in non-liver cirrhosis portosystemic shunt encephalopathy—four case series—10.20407/fmj.2020-0082189-72472189-7255https://doaj.org/article/39119421d4a74ae18d696b34ce5410012021-11-01T00:00:00Zhttps://www.jstage.jst.go.jp/article/fmj/7/4/7_2020-008/_pdf/-char/enhttps://doaj.org/toc/2189-7247https://doaj.org/toc/2189-7255We reported here four cases presenting with disturbance of consciousness over long periods of time and hyperammonemia. Two patients were on maintenance hemodialysis. Contrast-enhanced computed tomography (CT) of abdomen and balloon-occluded retrograde contrast venography revealed existence of a non-cirrhotic portosystemic shunt. Conservative treatment such as intravenous branched-chain amino acid administration and oral lactulose administration had only a modest effect in all patients. Improvements in symptoms were observed following the occlusion of the shunt path in three patients. Measurements of ammonia values would be the most important test for screening, but changes in Fischer’s ratio or indocyanine green (ICG) test values were also correlated with clinical symptoms. Neurologists should keep in mind the possibility of non-cirrhotic portosystemic shunts when they encounter patients with disturbance of consciousness. They should also remember that occlusion of the shunt pathway is an effective treatment.Fumika AzumaKazuya NokuraTetsuharu KakoYoshihiko HorimotoEiichi KatadaNaohide KondoYasuhiro ItoFujita Medical Societyarticleportosystemic shuntencephalopathyhyperammonemiainterventional radiologyMedicine (General)R5-920ENFujita Medical Journal, Vol 7, Iss 4, Pp 139-142 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
portosystemic shunt encephalopathy hyperammonemia interventional radiology Medicine (General) R5-920 |
| spellingShingle |
portosystemic shunt encephalopathy hyperammonemia interventional radiology Medicine (General) R5-920 Fumika Azuma Kazuya Nokura Tetsuharu Kako Yoshihiko Horimoto Eiichi Katada Naohide Kondo Yasuhiro Ito Clinical investigation in non-liver cirrhosis portosystemic shunt encephalopathy—four case series— |
| description |
We reported here four cases presenting with disturbance of consciousness over long periods of time and hyperammonemia. Two patients were on maintenance hemodialysis. Contrast-enhanced computed tomography (CT) of abdomen and balloon-occluded retrograde contrast venography revealed existence of a non-cirrhotic portosystemic shunt. Conservative treatment such as intravenous branched-chain amino acid administration and oral lactulose administration had only a modest effect in all patients. Improvements in symptoms were observed following the occlusion of the shunt path in three patients. Measurements of ammonia values would be the most important test for screening, but changes in Fischer’s ratio or indocyanine green (ICG) test values were also correlated with clinical symptoms. Neurologists should keep in mind the possibility of non-cirrhotic portosystemic shunts when they encounter patients with disturbance of consciousness. They should also remember that occlusion of the shunt pathway is an effective treatment. |
| format |
article |
| author |
Fumika Azuma Kazuya Nokura Tetsuharu Kako Yoshihiko Horimoto Eiichi Katada Naohide Kondo Yasuhiro Ito |
| author_facet |
Fumika Azuma Kazuya Nokura Tetsuharu Kako Yoshihiko Horimoto Eiichi Katada Naohide Kondo Yasuhiro Ito |
| author_sort |
Fumika Azuma |
| title |
Clinical investigation in non-liver cirrhosis portosystemic shunt encephalopathy—four case series— |
| title_short |
Clinical investigation in non-liver cirrhosis portosystemic shunt encephalopathy—four case series— |
| title_full |
Clinical investigation in non-liver cirrhosis portosystemic shunt encephalopathy—four case series— |
| title_fullStr |
Clinical investigation in non-liver cirrhosis portosystemic shunt encephalopathy—four case series— |
| title_full_unstemmed |
Clinical investigation in non-liver cirrhosis portosystemic shunt encephalopathy—four case series— |
| title_sort |
clinical investigation in non-liver cirrhosis portosystemic shunt encephalopathy—four case series— |
| publisher |
Fujita Medical Society |
| publishDate |
2021 |
| url |
https://doaj.org/article/39119421d4a74ae18d696b34ce541001 |
| work_keys_str_mv |
AT fumikaazuma clinicalinvestigationinnonlivercirrhosisportosystemicshuntencephalopathyfourcaseseries AT kazuyanokura clinicalinvestigationinnonlivercirrhosisportosystemicshuntencephalopathyfourcaseseries AT tetsuharukako clinicalinvestigationinnonlivercirrhosisportosystemicshuntencephalopathyfourcaseseries AT yoshihikohorimoto clinicalinvestigationinnonlivercirrhosisportosystemicshuntencephalopathyfourcaseseries AT eiichikatada clinicalinvestigationinnonlivercirrhosisportosystemicshuntencephalopathyfourcaseseries AT naohidekondo clinicalinvestigationinnonlivercirrhosisportosystemicshuntencephalopathyfourcaseseries AT yasuhiroito clinicalinvestigationinnonlivercirrhosisportosystemicshuntencephalopathyfourcaseseries |
| _version_ |
1718440543955976192 |