Case Report
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World J Gastroenterol. Nov 14, 2014; 20(42): 15910-15915
Published online Nov 14, 2014. doi: 10.3748/wjg.v20.i42.15910
Embolization of splenorenal shunt associated to portal vein thrombosis and hepatic encephalopathy
Letícia de Campos Franzoni, Fábio Cardoso de Carvalho, Rafael Gomes de Almeida Garzon, Fábio da Silva Yamashiro, Laís Augusti, Lívia Alves Amaral Santos, Mariana de Souza Dorna, Júlio Pinheiro Baima, Talles Bazeia Lima, Carlos Antonio Caramori, Giovanni Faria Silva, Fernando Gomes Romeiro
Letícia de Campos Franzoni, Fábio da Silva Yamashiro, Laís Augusti, Lívia Alves Amaral Santos, Mariana de Souza Dorna, Júlio Pinheiro Baima, Talles Bazeia Lima, Carlos Antonio Caramori, Giovanni Faria Silva, Fernando Gomes Romeiro, Internal Medicine Department, Gastroenterology Division, Botucatu Medical School, UNESP, 18 618 970 Botucatu, Sao Paulo, Brazil
Fábio Cardoso de Carvalho, Department of Internal Medicine, Division of Cardiology, Botucatu School of Medicine, UNESP Univ Estadual Paulista, Sao Paulo 18618-970, Brazil
Rafael Gomes de Almeida Garzon, Hospital do Coração do Instituto de Moléstias Cardiovasculares, São José do Rio Preto, Sao Paulo 15015-210, Brazil
Author contributions: Franzoni LC designed the study, conducted the patient and wrote the manuscript; Carvalho FC and Garzon RGA performed the embolization of the splenorenal shunt and provide angiographic images; Yamashiro FS, Augusti L, Santos LAA, Dorna MS, Baima JP, Lima TB, Caramori CA and Silva GF participated in data collection and in manuscript writing; and Romeiro FG conducted the patient, wrote and reviewed the article.
Correspondence to: Letícia de Campos Franzoni, MD, Internal Medicine Department, Gastroenterology Division, Botucatu Medical School, UNESP, Rubiao Junior District S/N, 18 618 970 Botucatu, Sao Paulo, Brazil. leticiafranzoni@hotmail.com
Telephone: +55-14-98118-2827 Fax: +55-14-38822238
Received: March 24, 2014
Revised: May 5, 2014
Accepted: June 21, 2014
Published online: November 14, 2014
Processing time: 237 Days and 18.8 Hours
Core Tip

Core tip: Portosystemic shunts are a cause of hepatic encephalopathy and decreased survival of cirrhotic patients. The embolization of these shunts has been performed to control hepatic encephalopathy manifestations, but the presence of portal vein thrombosis is considered a contraindication. We presented a cirrhotic patient with persistent hepatic encephalopathy and hepatic coma. She had a wide splenorenal shunt and also portal vein thrombosis. As she had other shunts, we performed the embolization of the largest shunt and she achieved a good recovery. In conclusion, for patients with many shunts and severe hepatic encephalopathy, one of these shunts can be successfully embolized.