Liver failure after huge portosystemic shunt occlusion by balloon-occluded retrograde transvenous obliteration: A case report

Abstract

We report a case of huge portosystemic shunt treated by balloon-occluded retrograde transvenous obliteration (BRTO). The patient was a 67-year-old female with liver cirrhosis, a huge portal-systemic shunt, hy-perammonemia, and thrombocytopenia. BRTO was performed because hepatic encephalopathy was suspected. The preoperative liver function was Child-Pugh class A, whereas the wedged hepatic venous pressure was 19 mmHg. Six months postoperatively, she had liver failure because of a gastroesophageal varix rupture. This case suggests that cases of BRTO for a huge shunt should be carefully considered in patients with liver cirrhosis.