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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2021; 9(2): 496-501
Published online Jan 16, 2021. doi: 10.12998/wjcc.v9.i2.496
Published online Jan 16, 2021. doi: 10.12998/wjcc.v9.i2.496
Portal hypertension exacerbates intrahepatic portosystemic venous shunt and further induces refractory hepatic encephalopathy: A case report
Ying-Hao Chang, Xiao-Lei Zhou, Dan Jing, Zhen Ni, Shan-Hong Tang, Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
Ying-Hao Chang, Zhen Ni, Department of Infectious Diseases, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
Author contributions: Chang YH and Zhou XL were the patient’s physicians, reviewed the literature and contributed to manuscript drafting; Jing D and Ni Z contributed to manuscript drafting and interpreted the imaging findings; Tang SH was responsible for the revision of the manuscript for important intellectual content; All authors have approved the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shan-Hong Tang, DPhil, MD, Associate Professor, Director, Doctor, Department of Gastroenterology, General Hospital of Western Theater Command, No. 270 Tianhui Road, Chengdu 610083, Sichuan Province, China. shanhongtang@163.com
Received: September 24, 2020
Peer-review started: September 24, 2020
First decision: October 27, 2020
Revised: November 8, 2020
Accepted: November 29, 2020
Article in press: November 29, 2020
Published online: January 16, 2021
Peer-review started: September 24, 2020
First decision: October 27, 2020
Revised: November 8, 2020
Accepted: November 29, 2020
Article in press: November 29, 2020
Published online: January 16, 2021
Core Tip
Core Tip: Intrahepatic portosystemic venous shunt (IPSVS) is a rare hepatic disease. Here we have reported a case that portal hypertension exacerbated IPSVS and resulted in hepatic encephalopathy. The decreased liver stiffness and the portal hypertension expanded IPSVS and significantly increased shunt flow. Then increased shunt ratio relieved portal hypertension, but it resulted in hyperammonia and eventually precipitated hepatic encephalopathy. This case highlights hemodynamic changes may exacerbate intrahepatic portosystemic shunt. Intervention or surgery should be carefully applied to patients with severe portal hypertension due to the risk of hemorrhage.