Resolution of hepatic encephalopathy following hepatic artery embolization in a patient with well-differentiated neuroendocrine tumor metastatic to the liver.

Journal Article (Journal Article)

Hepatic encephalopathy is considered a contraindication to hepatic artery embolization. We describe a patient with a well-differentiated neuroendocrine tumor metastatic to the liver with refractory hepatic encephalopathy and normal liver function tests. The encephalopathy was refractory to standard medical therapy with lactulose. The patient's mental status returned to baseline after three hepatic artery embolization procedures. Arteriography and ultrasound imaging before and after embolization suggest that the encephalopathy was due to arterioportal shunting causing hepatofugal portal venous flow and portosystemic shunting. In patients with a primary or metastatic well-differentiated neuroendocrine tumor whose refractory hepatic encephalopathy is due to portosystemic shunting (rather than global hepatic dysfunction secondary to tumor burden), hepatic artery embolization can be performed safely and effectively.

Full Text

Duke Authors

Cited Authors

  • Erinjeri, JP; Deodhar, A; Thornton, RH; Allen, PJ; Getrajdman, GI; Brown, KT; Sofocleous, CT; Reidy, DL

Published Date

  • June 2010

Published In

Volume / Issue

  • 33 / 3

Start / End Page

  • 610 - 614

PubMed ID

  • 19756861

Pubmed Central ID

  • PMC5635822

Electronic International Standard Serial Number (EISSN)

  • 1432-086X

Digital Object Identifier (DOI)

  • 10.1007/s00270-009-9698-0


  • eng

Conference Location

  • United States