Hepatic encephalopathy is a common sequela in cirrhotic patients, presenting with
a range of neurologic and psychiatric symptoms accompanied by hyperammonemia. This
disorder can occur in non-cirrhotic patients with a predisposing factor—portosystemic
shunts (PSSs) —which are challenging to diagnose. Understanding the anatomic courses
of PSSs can facilitate their diagnosis. PSSs can be classified as intrahepatic or
extrahepatic, depending on whether the shunts originate from intrahepatic or extrahepatic
portal veins (
1
). Common PSSs include gastrorenal, splenorenal, or paraumbilical shunts. However,
intrahepatic PSSs via the right adrenal vein have been reported rarely (
2
,
3
). Therefore, in this report, we present a non-cirrhotic patient with hepatic encephalopathy,
with imaging results suggesting an intrahepatic PSS via the right adrenal vein.To read this article in full you will need to make a payment
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References
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Article info
Publication history
Published online: December 05, 2020
Accepted:
October 4,
2020
Received in revised form:
September 16,
2020
Received:
September 4,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.