Successful Mx of Hepatic Encephalopathy due to intrahepatic
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Intrahepatic portosystemic venous shunt (PSS), which is communication between the intrahepatic portal veins and the systemic veins, has rarely been reported since the first report by Raskin et al. in 1964. Intrahepatic PSS is now encountered more frequently with the developments of diagnostic imaging. Clinical manifestations of intrahepatic PSS depend on the shunt flow, and a shunt with a high flow may cause hepatic encephalopathy. In this condition, portal blood flows directly into the systemic circulation without passing through the liver, causing hepatic encephalopathy.

The location of PSS is extrahepatic in most cases, but a few cases of intrahepatic PSS have been reported. This report describes a case of idiopathic portal hypertension (IPH) whose hepatic encephalopathy was successfully treated by combination therapy using partial splenic artery embolization (PSE) and transileocolic venous obliteration (TIO).

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