Imaging and clinical features in cirrhotic patients complicated with hepatocellular carcinoma with a large spontaneous splenorenal shunt.

Abstract

Imaging and clinical features in 6 cirrhotic patients complicated with small hepatocellular carcinoma with a large spontaneous splenorenal shunt were studied in comparison with control patients without such a collateral. The diameter of portal vein (PV) was smaller than that of splenic vein (SV) measuring on an angiogram and the diametric ratio (PV/SV) was significantly smaller than that in control group. This fact, the diameter of PV was smaller than that of SV, brings a clue to find out a splenorenal shunt on the first examination using ultrasonography. The endoscopic findings suggested that a large splenorenal shunt may prevent development of advanced esophageal varices. The increased risk of recurrence hepatic encephalopathy in the patients with a large splenorenal shunt was indicated by clinical findings, and the therapeutic procedure as transcatheter arterial embolization therapy may induce encephalopathy as well.