Abstract
Case 1 : A 65-year-old female patient was observed for cryptogenic liver cirrhosis by a local physician. She presented at our hospital with a decreased level of consciousness and a flapping tremor in August 2007.
Case 2 : A 73-year-old male patient was observed for HCV-related liver cirrhosis by a local physician. He presented at our hospital with a decreased level of consciousness in June 2007. Dynamic computed tomography (CT), ultrasonography and abdominal angiography detected three tumors compatible with hepatocellular carcinoma in segments 2 and 6 and 8 of the liver. Radiofrequency ablation (RFA) therapy for segment 8 of the liver was done. CT and abdominal angiography also showed the presence of a paraumbilical venous shunt and the reduction of volume of portal vein in both cases. We surgically ligated the paraumbilical vein during an open laparotomy in both cases, and conducted RFA therapy for segments 2 and 6 of the liver in case 2. After surgery, serum ammonia levels were reduced rapidly to the normal range and chronic encephalopathy improved in both cases. Dynamic CT performed after surgery showed the disappearance of paraumbilical venous shunt in both cases. No incidences of hepatic encephalopathy, esophageal varices, and ascites occurred during the follow-up period till now in both cases.
