Document Detail


The treatment of hepatic encephalopathy by colectomy: case report and review of the literature.
MedLine Citation:
PMID:  5831216     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 64-year-old alcoholic patient with cirrhosis and bleeding esophageal varices developed hepatic encephalopathy following portacaval shunt. The etiology of this syndrome is believed to be related to the absorption of toxic nitrogenous substances derived from the activity of bacteria in the large bowel. Treatment consisted of a low protein diet, frequent purgation, and oral neomycin. Even on a 20-g. protein diet the patient deteriorated to a state approaching coma. Colectomy with ileorectal anastomosis was performed with good result. The patient remained alert and active with no recurrences of cerebral disturbance while enjoying a 60-g. protein diet. No additional treatment was necessary. The literature on colectomy in the treatment of this condition, while brief, reports similar good results. Further trial of colectomy is recommended for cases refractory to more conservative methods of management.
Authors:
H Singer; A W Harrison; P W Aggett
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Canadian Medical Association journal     Volume:  93     ISSN:  0008-4409     ISO Abbreviation:  Can Med Assoc J     Publication Date:  1965 Oct 
Date Detail:
Created Date:  1965-12-08     Completed Date:  1965-12-08     Revised Date:  2010-06-22    
Medline Journal Info:
Nlm Unique ID:  0414110     Medline TA:  Can Med Assoc J     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  954-6     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Alcoholism / complications
Colectomy*
Diet Therapy
Esophageal and Gastric Varices / complications
Hepatic Encephalopathy / prevention & control*
Humans
Liver Cirrhosis / complications
Male
Middle Aged
Neomycin / therapeutic use
Portacaval Shunt, Surgical / adverse effects*
Chemical
Reg. No./Substance:
1404-04-2/Neomycin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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