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| 1 | Embolization of splenorenal shunt associated to portal vein thrombosis and hepatic encephalopathy显示文摘Hepatic encephalopathy(HE)is a cognitive disturbance characterized by neuropsychiatric alterations.It occurs in acute and chronic hepatic disease and also in patients with portosystemic shunts.The presence of these portosystemic shunts allows the passage of nitrogenous substances from the intestines through systemic veins without liver depuration.Therefore,the embolization of these shunts has been performed tocontrol HE manifestations,but the presence of portal vein thrombosis is considered a contraindication.In this presentation we show a cirrhotic patient with severe HE and portal vein thrombosis who was submitted to embolization of a large portosystemic shunt.Case report:a 57 years-old cirrhotic patient who had been hospitalized many times for persistent HE and hepatic coma,even without precipitant factors.She had a wide portosystemic shunt and also portal vein thrombosis.The abdominal angiography confirmed the splenorenal shunt and showed other shunts.The larger shunt was embolized through placement of microcoils,and the patient had no recurrence of overt HE.There was a little increase of esophageal and gastric varices,but no endoscopic treatment was needed.Since portosystemic shunts are frequent causes of recurrent HE in cirrhotic patients,portal vein thrombosis should be considered a relative contraindication to perform a shunt embolization.However,in particular cases with many shunts and severe HE,we found that one of these shunts can be safely embolized and this procedure can be sufficient to obtain a good HE recovery.In conclusion,we reported a case of persistent HE due to a wide portosystemic shunt associated with portal vein thrombosis.As the patient had other shunts,she was successfully treated by embolization of the larger shunt. | Letícia de Campos Franzoni Fábio Cardoso de Carvalho Rafael Gomes de Almeida Garzon Fábio da Silva Yamashiro Laís Augusti Lívia Alves Amaral Santos Mariana de Souza Dorna Júlio Pinheiro Baima Talles Bazeia Lima Carlos Antonio Caramori Giovanni Faria Silva Fernando Gomes Romeiro | 2014 | World Journal of Gastroenterology2014，20，42： | 6 |
| 2 | Correlation between cephalometric data and severity of sleep apnea显示文摘 | Silva VG Pinheiro LA Silveira PL | 2014 | Braz J Otorhinolaryngol2014，80，3： | 1 |
| 3 | Clinical risk factors for osteoporotic fractures in Brazilian women and men : the Brazilian Oste- oporosis Study 显示文摘 | Pinheiro MM Ciconetli RM Martini LA | 2009 | Osteoporos Int2009，20，3： | 1 |
| 4 | Is rs7566605 ,a SNP near INSIG2, associated with body mass in a randomized clinical trial of antipsycbotics in schizophrenia显示文摘 | Skelly T Pinheiro AP Lange LA | 2007 | Mol Psychiatry2007，12，： | 1 |
| 5 | Prevalence of Helieobacter pylori infection in advanced gastric carcinoma显示文摘 | Araujo-Filho I Brandao Neto J Pinheiro LA | 2006 | Arq Gastroenterol2006，43，4： | 1 |
| 6 | Prevalance of Helicobacter pylori infection in advanced gastric cancinoma显示文摘 | Araujo-Filho I Brandao-Neto J Pinheiro LA | 2006 | Arq Gastroenterol2006，43，4： | 1 |
| 7 | Prevalence of Helicobacterpylori infection in advanced gastric carcinoma显示文摘 | Araujo-Filho I Brandao-Neto J Pinheiro LA | 2006 | Arq Gastroenterol2006，43，4： | 1 |
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