Shimizu Kaori, Nakashima Munetoshi, Fujimoto Masumi, Tsuruta Shotaro, Morita Shigeki, Furukawa Ryuji, Mori Masakazu
Department of Internal Medicine, Japanese Red Cross Nagasaki Genbaku Hospital, Japan.
Nihon Shokakibyo Gakkai Zasshi. 2009 Dec;106(12):1764-9.
We encountered a case of portal-systemic shunt encephalopathy cured by balloon-occluded retrograde transvenous obliteration (B-RTO). A 73-year-old man had been observed for membranous nephropathy at our hospital since 1987. There was no past history of liver dysfunction. He was admitted with encephalopathy. Abdominal enhanced computed tomography showed a portosystemic shunt through the inferior mesenteric vein and right internal iliac vein. We diagnosed hepatic encephalopathy due to this porto-systemic shunt, and B-RTO was performed. After B-RTO, he has not had repeated encephalopathy. B-RTO can be effective for portosystemic encephalopathy. Inferior mesenteric-right internal iliac shunt encephalopathy is rare and our patient is the first case of B-RTO performed in cases with this shunt.
我们遇到一例经球囊闭塞逆行静脉栓塞术（B-RTO）治愈的门体分流性脑病病例。一名73岁男性自1987年起在我院接受膜性肾病观察。既往无肝功能障碍病史。他因脑病入院。腹部增强计算机断层扫描显示通过肠系膜下静脉和右髂内静脉的门体分流。我们诊断为由于这种门体分流导致的肝性脑病，并进行了B-RTO。B-RTO术后，他未再出现反复脑病。B-RTO对门体性脑病可能有效。肠系膜下-右髂内分流性脑病罕见，我们的患者是首例针对这种分流进行B-RTO治疗的病例。
