A case of idiopathic portal hypertension with ileal stenosis and hepatic encephalopathy.

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A 59-year-old woman with IPH underwent esophageal transection and splenectomy for esophageal varices 3 years before developing hepatic encephalopathy and ileus. The patient had hyperammonemia at the time of this admission, despite the absence of portosystemic shunting. Evident progression of narrowing and tortuosity of the intrahepatic portal and mesenteric veins was observed on comparison of angiographic images obtained in 1988 and 1991. Since there was a Stenosis of the ileum, partial small bowel resection and liver biopsy were performed. The stensosis of the ileum was due to scarring of an ulcer, and endothelial thickening of the intramural ileal veins was observed. In addition, fibrosis of the portal areas and narrowing of the peripheral portal veins were observed in the liver.<BR>To our knowledge, there has been no report of such a case of IPH with changes of the mesenteric veins and ileal stenosis.
社団法人日本肝臓学会の論文