1993 Volume 54 Issue 9 Pages 2339-2343
We experienced a case of Inose-type encephalopathy due to a gastro-renal veno-venous shunt, in which remarkable symptomatic remission was attained by operative ligation of the shunt.
A 67-year-old female was seen at the hospital because of syncope attack. Brain infarction was suspected. Neurological examination on admission revealed no abnormality, but trigeminal wave was observed by electroencephalogram. Abnormally increased blood ammonia level was noted. The patient was diagnosed as having a portal-systemic shunt and transferred to the department for operation. During the operation the shunt vessel, about 13mm in diameter, which flowed into the left renal vein was observed, and it was ligated and dissected. The patient was discharged on 43rd day after the operation. As of one year and six months after the operation, there have been no symptoms of the encephalopathy.
For Inose-type encephalopathy without severe liver disfunction like this case, surgical approach is recommended.
