Hepatic encephalopathy after portacaval shunt in a noncirrhotic child

Abstract

PoRTACAVAL SHUNTING is performed in adults and chi ldren with familial ( type 2) hypercholesterolemia, to lower p lasma lipid levels and postpone atherosclerot ic changes. 1'2 A more common indicat ion for surgical shunting is ex t rahepat ic portal venous obstruction. 3' 4 In bo th of these disorders, pat ients have noncir rhot ic livers. A l though exper imental animals with noncir rhot ic livers f requent ly develop hepat ic encephalopathy af ter por tacaval shunt ing, adul t h u m a n s rarely do so, 5 and this complicat ion is said not to occur in children. W e describe in detail the first such case in a child, to which br ief reference was made in a paper by Starz l et al?