Balloon-occluded retrograde transvenous obliteration was effective for hyperammonemia caused by chronic portal-systemic shunt encephalopathy in hemodialysis patient -A case report
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- Kojima Fumiko
- Shinjuku-Ishikawa Clinic
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- Ueda Mio
- Shinjuku-Ishikawa Clinic
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- Saitou Madoka
- Shinjuku-Ishikawa Clinic
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- Tanaka Yoshiko
- Shinjuku-Ishikawa Clinic
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- Karakama Yuko
- Department of Internal Medicine, Tama Medical Center
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- Koshiishi Tsuyoshi
- Department of Medical Radiology, Tama Medical Center
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- Nitta Kosaku
- Department of Internal Medicine, Kidney Center, Tokyo Women's Medical University
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- Akiba Takashi
- Department of Blood Purification, Kidney Center, Tokyo Women's Medical University
Bibliographic Information
- Other Title
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- 脾静脈-下大静脈短絡による高アンモニア血症を呈し，balloon-occluded retrograde transvenous obliteration;B-RTO（バルーン下逆行性経静脈的塞栓術）により著明に改善した血液透析患者の1例
- 症例報告 脾静脈-下大静脈短絡による高アンモニア血症を呈し,balloon-occluded retrograde transvenous obliteration ; B-RTO(バルーン下逆行性経静脈的塞栓術)により著明に改善した血液透析患者の1例
- ショウレイ ホウコク ヒジョウミャク-シタ ダイ ジョウミャク タンラク ニ ヨル コウアンモニア ケツショウ オ テイシ,balloon-occluded retrograde transvenous obliteration ; B-RTO(バルーン カ ギャッコウセイケイ ジョウミャクテキ ソクセンジュツ)ニ ヨリ チョメイ ニ カイゼン シタ ケツエキ トウセキ カンジャ ノ 1レイ
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Description
We present the case of a 68-year-old male hemodialysis patient who developed portal-systemic shunt encephalopathy. Hemodialysis was started owing to diabetic nephropathy in April 2000. He previously underwent partial gastrectomy for gastric ulcer and blood transfusion. Since September 2004, fecal incontinence, some cognitive symptoms, and depression have sometimes occurred. Although he had been a heavy drinker and was a hepatitis C virus carrier, abdominal echography and computed tomography (CT) did not indicate any evidence of liver cirrhosis, and laboratory examination findings were normal except for the serum ammonia level, which was elevated at 232μg/dL. Moreover, abdominal enhanced CT and angiography revealed a portal-systemic shunt from the splenic vein via the left testicular vein to the left renal vein. Despite treatment with a solution containing branched-chain amino acids (Aminoleban®), hyperammonemia did not improve. Balloon-occluded retrograde transvenous obliteration (B-RTO) was performed. The serum ammonia level was normalized and cognitive symptoms improved after the obliteration. During a 9-month follow-up period, there was no recurrence of encephalopathy.
Journal
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- Nihon Toseki Igakkai Zasshi
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Nihon Toseki Igakkai Zasshi 45 (3), 267-272, 2012
The Japanese Society for Dialysis Therapy
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Details 詳細情報について
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- CRID
- 1390001204677636480
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- NII Article ID
- 10030813542
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- NII Book ID
- AN10432053
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- ISSN
- 1883082X
- 13403451
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- NDL BIB ID
- 023634469
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL Search
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed
