PMC4325549_01
Computed tomography 3D reconstruction illustrating the portosystemic shunt.
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CT imaging showed features of liver cirrhosis with a prominent portosystemic shunt (Figure 1), leading to massively enlarged peristomal varices and excluded upper urinary tract bleeding.
Connect-the-numbers test to assess the grade of hepatic encephalopathy.
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However, neurologic assessment with connect-the-numbers test (Figure 2) revealed clinically relevant HE, making the patient not suitable for TIPS.
Angiography after coiling of the portosystemic shunt.
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In a second step, the portosystemic shunt was percutaneously embolized with a combination of coils and histoacryl/lipiodol (Figure 3).