Hepatic encephalopathy after liver transplantation in a patient with a normally functioning graft: Treatment with embolization of portosystemic collaterals

Abstract

Received April 5, 2008; accepted May 11, 2008.Portosystemic encephalopathy is one of the most im-portant complications of liver cirrhosis. The restorationof normal hepatic function and the reduction of porto-systemic shunts by means of a liver graft are followedby the resolution of hepatic encephalopathy. We reportthe case of a patient with a normal functioning graftthat developed recurrent encephalopathy after trans-plantation. The patient was successfully treated by em-bolization of a large portosystemic shunt between thesuperior mesenteric vein and both gonadal veins, thiscausing an inversion of the superior mesenteric veinflow.