Brain edema and portal-systemic encephalopathy

Portal systemic encephalopathy (PSE).

Sixtynine cases of portal systemic encephalopathy (PSE) (45 cirrhosis, 24 hepatitis) were seen during 15 months. Coma due to acute viral hepatitis occurred in a younger age group as compared to cirrhosis. Upper gastrointestinal bleeding and hepatic necrosis were the main precipitating factors. Most of the patients were in grade Ill (37.6%) and IV (34.7%) coma when first seen. Blood ammonia nitr...

Hemodialysis-related portal-systemic encephalopathy.

Hemodialysis-related portal-systemic encephalopathy (HRPSE) is characterized by the presence of portosystemic encephalopathy without liver dysfunction, usually caused by changes in the systemic venous flow related to hemodialysis. We herein describe the case of a 75-year-old woman who developed hepatic encephalopathy five years after the initiation of hemodialysis. Abdominal contrast-enhanced c...

Ammonia intoxication in portal systemic encephalopathy.

Portal systemic encephalopathy (PSE) comprises of five major features, of which ammonia intoxication of the central nervous system is the only specific feature. Ammonia is a key intermediate in the metabolism of nitrogen. Oxidative deamination of aminoacids is one of the major ammonia producing pathways. It occurs predominantly in the liver, to a lesser extent kidneys and also in the brain. The...

Chronic portal systemic encephalopathy: update 1987.

Management of acute portal systemic encephalopathy.