門脈圧亢進を伴なわない猪瀬型肝性脳症の1例

概要

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This is the report of a case 50-year-old man with recurrent hepatic encephalopathy in whom percutaneous transhepatic portography demonstrated a huge gastro-renal shunt without elevated portal vein pressure. He had repeated episodes of encephalopathy for the past twenty years with gradual aggravation. Percutaneous transhepatic portography demonstrated irregular tapering and peripheral narrowing of the intrahepatic portal branches, and liver biopsy demonstrated mild portal fibrosis and steatosis. Localized subcapsular atrophy with nodule formation was found by laparoscopy, and arteriographic findings were compatible. Congenital vascular abnormality does not explain the localized subcapsular atrophy, and it seems likely that idiopathic portal hypertension was the underlying disease which gave way to normalization of portal pressure after opening of the gastro-renal shunt and its enlargement.
社団法人日本肝臓学会の論文