Percutaneous transhepatic obliteration for hepatic encephalopathy accompanied with chronic renal failure in a super-elderly patient: A case report

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  • Watanabe Yusuke
    Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University
  • Ishikawa Toru
    Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital
  • Abe Satoshi
    Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital
  • Inoue Ryousuke
    Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University
  • Sugano Tomoyuki
    Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University
  • Iwanaga Akito
    Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital
  • Seki Keiichi
    Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital
  • Honma Terasu
    Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital
  • Yoshida Toshiaki
    Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital
  • Nemoto Takeo
    Department of Radiology, Saiseikai Niigata Daini Hospital
  • Takeda Keiko
    Department of Radiology, Saiseikai Niigata Daini Hospital
  • Terai Shuji
    Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University

Bibliographic Information

Other Title
  • 超高齢者慢性腎不全合併肝性脳症に対し，経皮経肝的門脈側副血行路塞栓術（Percutaneous transhepatic obliteration；PTO）を施行した一例
  • 症例報告 超高齢者慢性腎不全合併肝性脳症に対し,経皮経肝的門脈側副血行路塞栓術(Percutaneous transhepatic obliteration ; PTO)を施行した一例
  • ショウレイ ホウコク チョウコウレイシャ マンセイ ジンフゼン ガッペイ カンセイ ノウショウ ニ タイシ,ケイヒケイ カンテキ モンミャク ソクフク ケッコウロ ソクセンジュツ(Percutaneous transhepatic obliteration ; PTO)オ シコウ シタ イチレイ

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Abstract

We herein report the case of a super-elderly patient with hepatic encephalopathy accompanied with chronic renal failure, who successfully underwent percutaneous transhepatic obliteration (PTO). An 85-year-old man was diagnosed with non-alcoholic fatty liver cirrhosis and chronic renal failure. He had a collateral vessel from the left portal vein to the paraesophageal vein, which caused repeated hepatic encephalopathy, and medications poorly controlled his hepatic encephalopathy. PTO was performed using a half dose of contrast medium. After PTO, his portal vein pressure did not increase; however, he had respiratory discomfort with right pleural effusion on the fifth day. The pleural effusion disappeared on increasing the diuretic dose. Although the diuretic dose was increased, his renal function did not worsen and the NH3 level did not increase. Hepatic encephalopathy might be controlled by performing PTO in a super-elderly patient, with minimal reduction in renal function from contrast medium and diuretics.

Journal

  • Kanzo

    Kanzo 56 (12), 668-674, 2015

    The Japan Society of Hepatology

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