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Journal of hepatology · May 1989
Case ReportsReversal of hepatic encephalopathy and alteration in amino acid profiles after blocking a surgical splenorenal shunt by interventional radiological techniques.
- B Clarke, M J Ellis, V Leung, E Hughes, J H Meek, D J Allison, and H J Hodgson.
- Department of Medicine, Royal Postgraduate Medical School, London, U.K.
- J. Hepatol. 1989 May 1; 8 (3): 325-9.
AbstractPortal-systemic shunts are effective in preventing haemorrhage from varices in portal hypertension, but at the price of hepatic encephalopathy. We describe the blockage of a splenorenal shunt using interventional radiology, in a patient with incapacitating chronic encephalopathy. The procedure successfully reversed encephalopathy, without haemodynamic disturbances or haemorrhage from recurrent varices and was associated with a return of the plasma amino acid profile towards normal, with a reduction in aromatic amino acids and an increase in branch chain amino acids. This observation supports the hypothesis that changes in plasma amino acid profiles in patients with portal-systemic shunting are due to the diversion of portal blood rather than the underlying chronic liver disease.
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