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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 | Experimental investigation of welded built-up columns 显示文摘 | Estuar F R Tall L | 1963 | Welding Research Supplement1963，42，4： | 1 |
| 3 | The Reinforcement of Steel Columns显示文摘 | Tall L | 1989 | AISC Engineering Journal1989，26，1： | 1 |
| 4 | Residual-stress measurement by the 'sectioning method 显示文摘 | TEBEDGE N ALPSTEN G TALL L | 1973 | Experimental Mechanics1973，13，2： | 1 |
| 5 | Experimental investigation of welded built- up columns 显示文摘 | ESTUAR F R TALL L | 1963 | Welding Research Supplement1963，42，4： | 1 |
| 6 | Residual-stress measurement by the sectioning method显示文摘 | Tebedge N Alpsten G Tall L | 1973 | Experimental Mechanics1973，13，2： | 1 |
| 7 | The Reinforcement of Steel Columns 显示文摘 | Tall L | 1989 | Engineer- ing Journal American Institute of Steel Construction1989，26，1： | 1 |
| 8 | Role of HDL, ABCA1, and ABCG1 transporters in cholesterol efflux and immune responses 显示文摘 | Yvan-Charvet L Wang N Tall AR | 2010 | Arterioscler Thromb Vasc Biol2010，30，2： | 1 |
| 9 | Role of HDL, ABCA1, and ABCGI transporters in cholesterol efllux and immune responses 显示文摘 | Yvan-Charvet L Wang N Tall AR | 2010 | Arterioscler Thromb Va-c Biol2010，30，2： | 1 |
| 10 | Experimental Investigation of Welded Built- Up Columns 显示文摘 | Estuar F R Tall L | 1963 | Welding Journal1963，42，4： | 1 |
| 11 | The deposits of flows transitional between turbidity currents and debris flow显示文摘 | SUMNER E J TALLING P J AMY L A | 2009 | Geology2009，37，11： | 1 |
| 12 | The implications of the structure of the bactericidal:permeability-increasing protein on the lipid transfer function of the cholesteryl ester transfer protein 显示文摘 | BRUCE C BEAMER L J TALL A R | 1998 | Curr Opin Struct Biol1998，8，4： | 1 |
| 13 | Role of HDL, ABCA1, and ABCG1 transporters in cholesterol efflux and immune responses显示文摘 | Yvan-Charvet L Wang N Tall AR | 2010 | Arterioscl Throm Vas2010，30，2： | 1 |
| 14 | Residual-stress measurement by the sectioning method 显示文摘 | Tebedge N Alpsten G Tall L | 1973 | Experimental Mechanics1973，13，2： | 1 |
| 15 | HDL,ABC transporters,and cholesterol efflux:implications for the treatment of atherosclerosis显示文摘 | Tall A R Yvan-Charvet L Terasaka N | 2008 | Cell Metab2008，7，5： | 1 |
| 16 | HDL, ABC transporters, and cholesterol efflux: implications for the treatment of atherosclerosis 显示文摘 | Tall AR Yvan-Charvet L Terasaka N | 2008 | Cell Metab2008，7，： | 1 |
| 17 | Residual-Stress Measurement by the Sectioning Method显示文摘 | Tebedge N Alpsten G Tall L | 1973 | Experimental Mechanics1973，，13： | 1 |
| 18 | Facies architecture ofindividual basinplainturbidites:Comparison with existingmodels and implications for flow processes显示文摘 | Summer E J Talling P J Amy L A | 2012 | Sedimentology2012，59，6： | 1 |
| 19 | Role of HDL, ABCA1, and ABCG1 transporters in cholesterol efflux and immune re- sponses显示文摘 | Yvan-Charvet L Wang N Tall AR | 2010 | Arterioscler Thromb Vasc Biol2010，30，2： | 1 |
| 20 | Role of HDL, ABCAland ABCG1 transporters in cholesterol efflux and immune responses 显示文摘 | Yvan L Wang N Tall A R | 2010 | Arterioscler Thromb Vasc Bio!2010，30，2： | 1 |
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