We examined the effect of endoscopic injection sclerotherapy (EIS) and balloon-occluded retrograde obliteration (B-RTO) on neurophysiological (NP) functions of patients with subclinical hepatic encephalopathy (HE). The subjects were selected from patients with esophageal and gastric varices who were diagnosed as subclinical HE using the NP test. Of these, 8 patients who received EIS, 5 patients underwent B-RTO, and 5 patients were the control. In EIS and B-RTO groups, the NP tests were performed one day before the treatment and approximately one week after the completion of the treatment. In the control group, the test was performed twice at the interval of 1-2 weeks. The EIS treatment group showed significant improvement in either of number connection test-A and block design test after treatment (ρ<0.05). The B-RTO treatment group showed significant improvement in block design test after treatment (ρ<0.05). The control group showed no significant improvement in the second test. It was indicated that EIS and B-RTO improves HE.

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It is suggested clinically that ascites is due to chronic non-specific peritonitis. However, there have been no report on the alterations in the peritoneal membrane before the occurrence of ascites. We produced liver cirrhosis by oral administration of thioacetamide (TAA) in male Wistar rats to investigate sequential changes in cirrhotic peritoneal membrane. Animals were divided into three groups, group A : the stage of liver cirrhosis (LC); group B : LC accompanied by ascites, group C : age-matched normal rats. Results of the peritoneal equilibration test (PET), portal pressure, and histopathological findings of the liver and peritoneum were compared among the three groups.
The higher degree of fibrosis and higher portal pressure were observed in group A and B. Peritoneal functions of the cirrhotic rats were lower than those of group C, and those of group B were lower than group A. Histopathological studies indicated that fibrosis developed in the deep layer of the peritoneum and mesothelial cells were altered in group A and B, and these changes were more remarkable in group B.
These observations suggest that chronic non-specific peritonitis develops prior to the appearance of ascites, and it contributes the pathogenesis of ascites in liver cirrhosis.

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[in Japanese]

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[in Japanese]

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