Hiromi ISHIBASHI, Mamoru KUROKAWA, Masaaki NAKAYAMA, Kazuhiro HAYASHIDA, Yoshiyuki NIHO

The First Department of Internal Medicine, Faculty of Medicine, Kyushu University

キーワード : Portal-systemic shunt, Hepatic encephalopathy, Cirrhosis, Ultrasonography

Portal-systemic shunting from the superior mesenteric vein into the inferior vena cava at the ileocecal region was demonstrated by ultrasonography. Venous hum was audible at the region. The shunting was documented by digital subtraction angiography. Thus, encephalopathy of this patient was considered to be due to portal-systemic encephalopathy in addition to reduced liver function rather than that of cirrhosis in the terminal stage. Shunting between these two vessels is exceedingly rare. However, careful physical examination and sonographical scanning may lead to diagnosis.