Abstract
A case of portal-systemic encephalopathy with a large left gastric-left renal shunt is reported. Superior mesenteric arterial portography revealed that a large amount of superior mesenteric venous flow shunted to the inferior vena cava via the left gastric-left renal shunt, and the ratio of the collateral/portal diameter was 2.3. The shunt occlusion test was performed using a balloon catheter in order to investigate the changes in portal circulation after shunt closure. After the occlusion, portal venous pressure rose from 11.0cmH2O to 24.5cmH2O and estimated hepatic blood flow in-creased from 342ml/min/m2 to 923ml/min/m2. Recently, shunt closure surgery has been performed for the treatment of portal-systemic encephalopathy. This report suggested that it would be useful to examine the changes in portal circulation by the shunt occlusion test using a balloon catheter in order to evaluate the effects of this operation preoperatively.
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