Portosystemic shunts and refractory hepatic encephalopathy: patient selection and current options
Cyriac Abby Philips, Sasidharan Rajesh, Philip Augustine, Guruprasad Padsalgi, Rizwan Ahamed The Liver Unit, Cochin Gastroenterology Group, Ernakulam Medical Centre, Cochin, Kerala, India Abstract: Portosystemic shunt (PS) syndrome encompasses a spectrum of disease manifestations ranging from asympt...
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Dove Medical Press
2019
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oai:doaj.org-article:a7cf3f8a052e4d92b3de9cb63d5fa6be2021-12-02T06:19:20ZPortosystemic shunts and refractory hepatic encephalopathy: patient selection and current options1179-1535https://doaj.org/article/a7cf3f8a052e4d92b3de9cb63d5fa6be2019-01-01T00:00:00Zhttps://www.dovepress.com/portosystemic-shunts-and-refractory-hepatic-encephalopathy-patient-sel-peer-reviewed-article-HMERhttps://doaj.org/toc/1179-1535Cyriac Abby Philips, Sasidharan Rajesh, Philip Augustine, Guruprasad Padsalgi, Rizwan Ahamed The Liver Unit, Cochin Gastroenterology Group, Ernakulam Medical Centre, Cochin, Kerala, India Abstract: Portosystemic shunt (PS) syndrome encompasses a spectrum of disease manifestations ranging from asymptomatic portal hypertension to recurrent and refractory hepatic encephalopathy, ultimately culminating in progressive hepatic failure in patients of cirrhosis and associated large PSs. PSs commonly seen in cirrhosis include splenorenal, gastrorenal, and dilated paraumbilical veins, all of which can present with recurrent or refractory hepatic encephalopathy. In this exhaustive review, we describe the anatomy of PSs, elucidate new theories on their pathophysiology, discuss the clinical implications of PSs in cirrhosis, provide details on different techniques (classical and novel) of shunt embolization, and explore all the pertinent current literature on shunt embolization for refractory and recurrent hepatic encephalopathy, all of which are enumerated with extensive images and illustrations. Keywords: portosystemic shunts, hepatic encephalopathy, cirrhosis, portal hypertension, embolization, shunt occlusionPhilips CARajesh SAugustine PPadsalgi GAhamed RDove Medical Pressarticleportosystemic shuntshepatic encephalopathycirrhosisportal hypertensionembolizationshunt occlusionDiseases of the digestive system. GastroenterologyRC799-869ENHepatic Medicine: Evidence and Research, Vol Volume 11, Pp 23-34 (2019) |
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DOAJ |
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DOAJ |
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EN |
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portosystemic shunts hepatic encephalopathy cirrhosis portal hypertension embolization shunt occlusion Diseases of the digestive system. Gastroenterology RC799-869 |
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portosystemic shunts hepatic encephalopathy cirrhosis portal hypertension embolization shunt occlusion Diseases of the digestive system. Gastroenterology RC799-869 Philips CA Rajesh S Augustine P Padsalgi G Ahamed R Portosystemic shunts and refractory hepatic encephalopathy: patient selection and current options |
| description |
Cyriac Abby Philips, Sasidharan Rajesh, Philip Augustine, Guruprasad Padsalgi, Rizwan Ahamed The Liver Unit, Cochin Gastroenterology Group, Ernakulam Medical Centre, Cochin, Kerala, India Abstract: Portosystemic shunt (PS) syndrome encompasses a spectrum of disease manifestations ranging from asymptomatic portal hypertension to recurrent and refractory hepatic encephalopathy, ultimately culminating in progressive hepatic failure in patients of cirrhosis and associated large PSs. PSs commonly seen in cirrhosis include splenorenal, gastrorenal, and dilated paraumbilical veins, all of which can present with recurrent or refractory hepatic encephalopathy. In this exhaustive review, we describe the anatomy of PSs, elucidate new theories on their pathophysiology, discuss the clinical implications of PSs in cirrhosis, provide details on different techniques (classical and novel) of shunt embolization, and explore all the pertinent current literature on shunt embolization for refractory and recurrent hepatic encephalopathy, all of which are enumerated with extensive images and illustrations. Keywords: portosystemic shunts, hepatic encephalopathy, cirrhosis, portal hypertension, embolization, shunt occlusion |
| format |
article |
| author |
Philips CA Rajesh S Augustine P Padsalgi G Ahamed R |
| author_facet |
Philips CA Rajesh S Augustine P Padsalgi G Ahamed R |
| author_sort |
Philips CA |
| title |
Portosystemic shunts and refractory hepatic encephalopathy: patient selection and current options |
| title_short |
Portosystemic shunts and refractory hepatic encephalopathy: patient selection and current options |
| title_full |
Portosystemic shunts and refractory hepatic encephalopathy: patient selection and current options |
| title_fullStr |
Portosystemic shunts and refractory hepatic encephalopathy: patient selection and current options |
| title_full_unstemmed |
Portosystemic shunts and refractory hepatic encephalopathy: patient selection and current options |
| title_sort |
portosystemic shunts and refractory hepatic encephalopathy: patient selection and current options |
| publisher |
Dove Medical Press |
| publishDate |
2019 |
| url |
https://doaj.org/article/a7cf3f8a052e4d92b3de9cb63d5fa6be |
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