Refractory and Severe Hepatogenous Diabetes in a Patient with Cirrhosis Improved by Balloon-Occluded Retrograde Transvenous Obliteration of a Large Portosystemic Shunt.
Cardiovasc Intervent Radiol
; 44(6): 988-991, 2021 Jun.
Article
em En
| MEDLINE
| ID: mdl-33709280
ABSTRACT
A 54-year-old male with liver cirrhosis (Child-Pugh score 5) presented with severe hepatogenous diabetes (HbA1c 12.6%). Contrast-enhanced CT showed a large portosystemic shunt from the inferior mesenteric vein to the left internal iliac vein. Glucose monitoring showed postprandial hyperglycemia and reactive hypoglycemia. After balloon-occluded retrograde transvenous obliteration (BRTO) and partial splenic transarterial embolization, postprandial hyperglycemia was diminished. Seven months later, HbA1c had improved from 12.6% to 6.7%. In this case, postprandial hyperglycemia occurred by direct delivery of glucose into the systemic circulation via the shunt, and fasting hypoglycemia occurred during treatment with oral antidiabetic agents and insufficient gluconeogenesis. BRTO of the portosystemic shunt resulted in improvement in hepatogenous diabetes.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fístula Arteriovenosa
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Oclusão com Balão
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Diabetes Mellitus Tipo 2
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Embolização Terapêutica
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Cirrose Hepática
Limite:
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Cardiovasc Intervent Radiol
Ano de publicação:
2021
Tipo de documento:
Article