Presentation
We present a case with hepatic myelopathy (HM) due to a surgical splenorenal shunt that was successfully treated by endovascular interventional techniques. [ncbi.nlm.nih.gov]
Entire Body System
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Noncompliance
CONCLUSIONS: Splenorenal shunt is an important treatment for noncompliant patients or patients living in remote areas where access to specialized treatments, such as endoscopy, transjugular intrahepatic portosystemic shunt, ultrasonography, and liver [ncbi.nlm.nih.gov]
Neurologic
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Myelopathy
Hepatic myelopathy is a rare complication of chronic liver disease that is associated with extensive portosystemic shunts. [ncbi.nlm.nih.gov]
Workup
After an extensive workup, he was found to have hyperammonemia and encephalopathy due to formation of a spontaneous splenorenal shunt. There was no evidence of cirrhosis on biopsy or imaging and no portal hypertension when directly measured. [ncbi.nlm.nih.gov]
The workup should include the following: Routine blood tests, including blood type and screen (indirect Coombs test), complete blood cell count, basic metabolic panel, liver function tests, prothrombin time, and partial thromboplastin time Doppler ultrasonography [mdedge.com]
Treatment
CONCLUSIONS: Splenorenal shunt is an important treatment for noncompliant patients or patients living in remote areas where access to specialized treatments, such as endoscopy, transjugular intrahepatic portosystemic shunt, ultrasonography, and liver [ncbi.nlm.nih.gov]
Prognosis
The clinical findings and prognosis were examined with respect to portal hemodynamics including collateral vessel patterns, with or without the presence of SRS or short gastric vein (SGV). Median observation period was 30 months. [ncbi.nlm.nih.gov]
Prognosis after Distal Splenorenal Shunt: The prognosis for a positive end result following distal splenorenal shunt is good. Recovery from Distal Splenorenal Shunt: Total recovery from distal splenorenal shunt takes four to six weeks. [orangecountysurgeons.org]
Outlook (Prognosis) After DSRS surgery, bleeding is controlled in most people with portal hypertension. The highest risk of bleeding again is in the first month after surgery. References Dudeja V, Fong Y. The liver. [mountsinai.org]
Etiology
Portal flow to the liver is maintained in 90% of patients with nonalcoholic etiology of portal hypertension and in 50% to 84% of patients with alcoholic cirrhosis depending on the degree of portal-azygos disconnection. [link.springer.com]
Other etiologies of portal hypertension—portal vein thrombosis or noncirrhotic portal fibrosis, in which patients have normal liver function—need to be defined early in the evaluation, because the long-term prognosis depends on best prevention of variceal [clinicalgate.com]
Etiology and pathogenesis The portal vein is composed of the product of the transhepatic blood flow and the flow resistance in its current path. [memim.com]
[…] of Portal Hypertension Etiology HCV cirrhosis HBV cirrhosis HBV HCV cirrhosis Alcoholic cirrhosis Primary biliary cirrhosis Cryptogenic cirrhosis Non-B non-C chronic active hepatitis Chronic active HBV Portal vein thrombosis Portal vein thrombosis No [ayubmed.edu.pk]
The etiology, presentation and natural history of portal venous obstruction. Quarterly Journal of Medicine 1979;48:627-39. 12. Van Stiegmann G, Cambre T, Sun JH. A new endoscopic elastic band ligating device. Gastrointest Endosc 1986;32:230-3. 13. [jmedsoc.org]
Epidemiology
Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]
Pathophysiology
Possible mechanisms of the pathophysiology are discussed and recommendations made on this basis for the selection of such patients for portal decompression. [ncbi.nlm.nih.gov]
With further clarification of the underlying pathophysiology and technological advances that have facilitated progress in both diagnosis and treatment, the goal of safe, selective management of patients presenting with variceal hemorrhage is closer to [karger.com]
A pathophysiologic, gastroenterologic, and radiologic approach to the management of gastric varices. Gastroenterology. 2004; 126 1175-1189 3 Trudeau W, Prindiville T. Endoscopic injection sclerosis in bleeding gastric varices. [thieme-connect.com]
Prevention
CONCLUSIONS: TIPS is as effective as DSRS in preventing variceal rebleeding and may be more cost effective. TIPS, in all aspects, is equal to DSRS in the prevention of variceal rebleeding in patients who are medical failures. [ncbi.nlm.nih.gov]