Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
CASE 315 SPONTANEOUS PORTO-SYSTEMIC SHUNT, Dr PHAN
THANH HAI, Dr NGUYEN THI ANH HONG, Dr LE THONG NHAT, Dr
TRAN LAM
Woman ...
snake. In 3D CT reconstruction confirmed a high flow porta-systemic
shunting).
Bood test reports at this time no ceton , h...
Upcoming SlideShare
Loading in …5
×

CASE 315 : SPONTANOUS PORTOSYSTEMIC SHUNT, Dr PHAN THANH HẢI

256 views

Published on

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

CASE 315 : SPONTANOUS PORTOSYSTEMIC SHUNT, Dr PHAN THANH HẢI

  1. 1. CASE 315 SPONTANEOUS PORTO-SYSTEMIC SHUNT, Dr PHAN THANH HAI, Dr NGUYEN THI ANH HONG, Dr LE THONG NHAT, Dr TRAN LAM Woman 63 yo 5 years ago had been treated diabetes not control blood sugar. Patient has some subcoma crisii that had been treated in many hospitals, now she is somnolent, easy in sleeping after eating.but cannot sleep at night. MRI of the brain, radiologist detected hyperintense T1 at basal ganglion area, suggested hepato-encepalopathy (image MRI). Checking the liver by blood tests, liver function is still good, but ultrasound of liver detected porta-systemic vein shunting in very high flow ( see US image 1 dilatation cystic intrahepatic, US 2, color Doppler: porta-systemic shunting and US video) MSCT angio of liver with 3 phases: arterial phase shows that not abnormal; venous phase : dilated the porta-hepatic anastomosis like
  2. 2. snake. In 3D CT reconstruction confirmed a high flow porta-systemic shunting). Bood test reports at this time no ceton , high NH3 = 88,89 mmol/mL (normal 18-72) Conclusion: It is a high flow spontaneous porta-systemic shunting appeared as hepatic encephalopathy in clinical examination.

×