Reversal of hepatic encephalopathy and alteration in amino acid profiles after blocking a surgical splenorenal shunt by interventional radiological techniques.

Abstract

Portal-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.

• Authors: B Clarke, M J Ellis, V Leung, E Hughes, J H Meek, D J Allison, H J Hodgson
• Journal: Journal of hepatology (J Hepatol) Vol. 8 Issue 3 Pg. 325-9 (May 1989) ISSN: 0168-8278 [Print] Netherlands
• PMID: 2732446 (Publication Type: Case Reports, Journal Article)

Chemical References

• Amino Acids

Topics

• Amino Acids (blood)
• Female
• Hepatic Encephalopathy (blood, diagnostic imaging, etiology, therapy)
• Humans
• Liver Function Tests
• Portasystemic Shunt, Surgical (adverse effects)
• Radiography