Abstract
Clinicians should recognize extrahepatic portosystemic shunt as a cause of refractory or intermittent hepatic encephalopathy. Treatment strategies should be individualized according to patients' anatomic and hemodynamic status.
Highlights
A 70-year-old woman was admitted to our hospital with a 2-week history of intermittent altered mental status
She had known cirrhosis due to alcoholic hepatitis, but she had not had any similar symptoms in the past
The shunt was considered to be secondary to portal hypertension and large,combination therapy with lactulose and rifaximin was initiated, which improved her mental status
Summary
A 70-year-old woman was admitted to our hospital with a 2-week history of intermittent altered mental status. She had known cirrhosis due to alcoholic hepatitis, but she had not had any similar symptoms in the past. But no hepatomegaly and caput medusae were noted.
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