Congenital Intrahepatic Portosystemic Venous Shunt Presenting with Paraparesis as the Initial Symptom

An 85-year-old woman was hospitalized with rapidly progressive paraparesis without altered consciousness, although she was not definitively diagnosed. She developed acute drowsiness and disorientation several days later. An intrahepatic portosystemic venous shunt (IPSVS) was observed on enhanced com...

Full description

Saved in:
Bibliographic Details
Published inInternal Medicine Vol. 52; no. 21; pp. 2439 - 2442
Main Authors Torigoe, Masataka, Maeshima, Keisuke, Takeshita, Yasushi
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.01.2013
Subjects
Online AccessGet full text

Cover

Loading…
More Information
Summary:An 85-year-old woman was hospitalized with rapidly progressive paraparesis without altered consciousness, although she was not definitively diagnosed. She developed acute drowsiness and disorientation several days later. An intrahepatic portosystemic venous shunt (IPSVS) was observed on enhanced computed tomography, and hyperammonemia suggested leakage of neurotoxins from the shunt as the etiology of the patient's symptoms. Her neurological symptoms and hyperammonemia improved following transcatheter shunt embolization. We diagnosed her with hepatic myelopathy, which is a rare complication of liver cirrhosis and portosystemic venous shunts. Hepatic myelopathy resulting from a congenital IPSVS has not been previously reported. A diagnosis of hepatic myelopathy should be ruled out in diagnostically difficult cases of paraparesis.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.52.0881