“Combined balloon, plug and coil assisted retrograde transvenous obliteration of multiple porto-systemic shunts to treat recurrent hepatic encephalopathy: A Case Report”

We describe a patient who underwent balloon and plug-assisted obliteration for a lienorenal and lienogonadal shunt respectively. He returned with symptoms of recurrent hepatic encephalopathy two years later due to re-formation of new lienorenal and lienogonadal shunts. Repeat obliteration of these new shunts was now performed using balloon and coilassistance. We describe the treatment for multiple porto-systemic shunts with combined usage of vascular-plug, balloon and coils depending on anatomical and technically factors. Our case also highlights that after shunt obliteration increased portal pressure may form new portosystemic collateral pathways which leads to clinical failure and may require repeat treatment.
Source: Journal of Clinical and Experimental Hepatology - Category: Gastroenterology Source Type: research