Biomaterial Database

Prospective study of portasystemic encephalopathy after emergency portacaval shunt for bleeding varices. 1981

R H Bell, and P V Hyde, and W P Skivolocki, and J E Brimm, and M J Orloff

A prospective study of the development of encephalopathy was undertaken in 180 patients undergoing emergency portacaval shunt for bleeding esophageal varices between 1963 and 1978. The incidence of preoperative encephalopathy was 32 percent. Postoperatively, encephalopathy developed in 31.5 percent of 95 survivors and was severe in 7 percent of those survivors. Encephalopathy developed in most patients in the first and second follow-up years; in 10 year survivors, encephalopathy was virtually absent. Encephalopathy was more likely to occur in patients with encephalopathy at the time of shunt and in those who returned to alcoholism after shunt. Most encephalopathic episodes were precipitated by dietary indiscretion, often associated with alcoholism. Careful follow-up with attention to dietary compliance and abstinence from alcohol should make the risk of encephalopathy acceptable in relation to the unquestionable benefits of portacaval shunt in reducing the risk of variceal hemorrhage.

UI	MeSH Term	Description	Entries
D008104	Liver Cirrhosis, Alcoholic	FIBROSIS of the hepatic parenchyma due to chronic excess ALCOHOL DRINKING.	Alcoholic Cirrhosis,Hepatic Cirrhosis, Alcoholic,Alcoholic Hepatic Cirrhosis,Alcoholic Liver Cirrhosis
D009748	Nutrition Disorders	Disorders caused by nutritional imbalance, either overnutrition or undernutrition.	Nutritional Disorders,Nutrition Disorder,Nutritional Disorder
D011167	Portacaval Shunt, Surgical	Surgical portasystemic shunt between the portal vein and inferior vena cava.	Eck Fistula,Portacaval Anastomosis,Portacaval Shunt,Shunt, Surgical Portacaval,Surgical Portacaval Shunt,Anastomoses, Portacaval,Anastomosis, Portacaval,Fistula, Eck,Portacaval Anastomoses,Portacaval Shunts,Portacaval Shunts, Surgical,Shunt, Portacaval,Shunts, Portacaval,Shunts, Surgical Portacaval,Surgical Portacaval Shunts
D011184	Postoperative Period	The period following a surgical operation.	Period, Postoperative,Periods, Postoperative,Postoperative Periods
D004044	Dietary Proteins	Proteins obtained from foods. They are the main source of the ESSENTIAL AMINO ACIDS.	Proteins, Dietary,Dietary Protein,Protein, Dietary
D004630	Emergencies	Situations or conditions requiring immediate intervention to avoid serious adverse results.	Emergency
D004932	Esophageal and Gastric Varices	Dilated blood vessels in the ESOPHAGUS or GASTRIC FUNDUS that shunt blood from the portal circulation (PORTAL SYSTEM) to the systemic venous circulation. Often they are observed in individuals with portal hypertension (HYPERTENSION, PORTAL).	Esophageal Varices,Gastric Varices,Esophageal Varix,Gastric Varix,Varices, Esophageal,Varices, Gastric,Varix, Esophageal,Varix, Gastric
D006471	Gastrointestinal Hemorrhage	Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM.	Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias
D006501	Hepatic Encephalopathy	A syndrome characterized by central nervous system dysfunction in association with LIVER FAILURE, including portal-systemic shunts. Clinical features include lethargy and CONFUSION (frequently progressing to COMA); ASTERIXIS; NYSTAGMUS, PATHOLOGIC; brisk oculovestibular reflexes; decorticate and decerebrate posturing; MUSCLE SPASTICITY; and bilateral extensor plantar reflexes (see REFLEX, BABINSKI). ELECTROENCEPHALOGRAPHY may demonstrate triphasic waves. (From Adams et al., Principles of Neurology, 6th ed, pp1117-20; Plum & Posner, Diagnosis of Stupor and Coma, 3rd ed, p222-5)	Encephalopathy, Hepatic,Portosystemic Encephalopathy,Encephalopathy, Hepatocerebral,Encephalopathy, Portal-Systemic,Encephalopathy, Portosystemic,Fulminant Hepatic Failure with Cerebral Edema,Hepatic Coma,Hepatic Stupor,Hepatocerebral Encephalopathy,Portal-Systemic Encephalopathy,Coma, Hepatic,Comas, Hepatic,Encephalopathies, Hepatic,Encephalopathies, Hepatocerebral,Encephalopathies, Portal-Systemic,Encephalopathies, Portosystemic,Encephalopathy, Portal Systemic,Hepatic Comas,Hepatic Encephalopathies,Hepatic Stupors,Hepatocerebral Encephalopathies,Portal Systemic Encephalopathy,Portal-Systemic Encephalopathies,Portosystemic Encephalopathies,Stupor, Hepatic,Stupors, Hepatic
D006760	Hospitalization	The confinement of a patient in a hospital.	Hospitalizations