Colonic Exclusion for Chronic Portal-Systemic Encephalomyelopathy
Authors: D. P. STABLES
Journal: Annals of Internal Medicine (1966)

Case Studies1 August 1966Colonic Exclusion for Chronic Portal-Systemic EncephalomyelopathyD. P. STABLES, M.B., B. LEVIN, M.B., B.CH., G. A. ELLIOTT, M.D., F.R.C.P., D. J. DUPLESSIS, CH.M., F.R.C.S.D. P. STABLES, M.B.Search for more papers by this author, B. LEVIN, M.B., B.CH.Search for more papers by this author, G. A. ELLIOTT, M.D., F.R.C.P.Search for more papers by this author, D. J. DUPLESSIS, CH.M., F.R.C.S.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-2-326 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe surgical relief of portal hypertension by portacaval anastomosis confers freedom from life-threatening hemorrhage in the majority of instances, but the risk of subsequent neurological and psychiatric change is high. Few patients regain their previous intellectual ability (1), and 18 (2) to 33% (1) experience recognizable attacks of portal-systemic encephalopathy. Conventional therapy with limited protein intake, oral antibiotics, and regular purgation will control or prevent most of these episodes, but a number of patients are intellectually crippled by chronic encephalopathy. A few have been reclaimed by removal or exclusion of the colon, the major source of ammonia production in the...References1. READLAIDLAWSHERLOCK AEJLS: Neuropsychiatric complications of portacaval anastomosis. Lancet 1: 961, 1961. CrossrefMedlineGoogle Scholar2. MCDERMOTTPALAZZINARDIMONDET WVHGLA: Elective portal systemic shunt. An analysis of 237 cases. New Eng. J. Med. 264: 419, 1961. CrossrefMedlineGoogle Scholar3. DINTZISHASTINGS RZAB: The effect of antibiotics on urea breakdown in mice. Proc. Nat. Acad. Sci. USA 39: 571, 1953. CrossrefMedlineGoogle Scholar4. 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To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Johannesburg,From the Departments of Medicine and Surgery, University of the Witwatersrand and the Johannesburg Hospital, Johannesburg, South Africa.This study was supported by the Council for Scientific and Industrial Research of South Africa.Requests for reprints should be addressed to D. P. Stables, M.B., Department of Medicine, University of the Witwatersrand Medical School, Hospital St., Johannesburg, South Africa. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByUse of model for end-stage liver disease exception points for early liver transplantation and successful reversal of hepatic myelopathy with a review of the literatureThe Role of Liver Transplantation in the Treatment of Hepatic Myelopathy: Case Report With Review of the LiteraturePortosystemic myelopathy: Spastic paraparesis after portosystemic shuntingHepatic myelopathy Case report with review of the literatureHepatic Encephalopathy: Current StatusIntestinal bacterial flora after total and partial colon resection 1 August 1966Volume 65, Issue 2Page: 326-329KeywordsAmmoniaAntibioticsBrain diseasesColonHemorrhageHospital medicineParaplegiaPortal hypertensionProteinsSurgery Issue Published: 1 August 1966 PDF DownloadLoading ...