Resolution of hepatic encephalopathy following hepatic artery embolization in a patient with well-differentiated neuroendocrine tumor metastatic to the liver Journal Article

   


Authors: Erinjeri, J. P.; Deodhar, A.; Thornton, R. H.; Allen, P. J.; Getrajdman, G. I.; Brown, K. T.; Sofocleous, C. T.; Reidy, D. L.
Article Title: Resolution of hepatic encephalopathy following hepatic artery embolization in a patient with well-differentiated neuroendocrine tumor metastatic to the liver
Abstract: Hepatic encephalopathy is considered a contraindication to hepatic artery embolization. We describe a patient with a well-differentiated neuroendocrine tumor metastatic to the liver with refractory hepatic encephalopathy and normal liver function tests. The encephalopathy was refractory to standard medical therapy with lactulose. The patient's mental status returned to baseline after three hepatic artery embolization procedures. Arteriography and ultrasound imaging before and after embolization suggest that the encephalopathy was due to arterioportal shunting causing hepatofugal portal venous flow and portosystemic shunting. In patients with a primary or metastatic welldifferentiated neuroendocrine tumor whose refractory hepatic encephalopathy is due to portosystemic shunting (rather than global hepatic dysfunction secondary to tumor burden), hepatic artery embolization can be performed safely and effectively. © Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2009.
Keywords: adult; human tissue; treatment outcome; case report; artificial embolism; hepatic encephalopathy; follow up; computer assisted tomography; tumor volume; differential diagnosis; tumor differentiation; neuroendocrine tumor; malaise; liver metastasis; disease severity; whole body imaging; hepatomegaly; echography; ondansetron; therapy effect; octreotide; liver function test; tumor growth; mental deterioration; alcohol consumption; paraneoplastic syndrome; portal hypertension; lethargy; hepatic artery embolization; liver biopsy; liver angiography; hepatic artery; cefazolin; ammonia; lactulose; rifaximin; ammonia blood level; disorientation; flapping tremor; liver arteriography
Journal Title: CardioVascular and Interventional Radiology
Volume: 33
Issue: 3
ISSN: 0174-1551
Publisher: Springer  
Date Published: 2010-06-01
Start Page: 610
End Page: 614
Language: English
DOI: 10.1007/s00270-009-9698-0
PROVIDER: scopus
PUBMED: 19756861
PMCID: PMC5635822
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-77953167623&partnerID=40&md5=cab9d34b8bffbc94917b37097e9068e2
Notes: --- - "Export Date: 20 April 2011" - "CODEN: CARAD" - "Source: Scopus"
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MSK Authors
  1. George I Getrajdman
    118 Getrajdman
  2. Diane Lauren Reidy
    294 Reidy
  3. Peter Allen
    501 Allen
  4. Ajita Deodhar
    11 Deodhar
  5. Karen T Brown
    178 Brown
  6. Joseph Patrick Erinjeri
    203 Erinjeri
  7. Constantinos T Sofocleous
    245 Sofocleous
  8. Raymond H Thornton
    84 Thornton
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