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Results of Surgery for Portacaval Shunt in a Patient with Situs Inversus Diagnosed and Evaluated by Per Rectal Portal Scintigraphy

Third Department of Internal Medicine and Division of Nuclear Medicine, Osaka City University Medical School, Osaka, Japan

Correspondence: For correspondence or reprints contact Dr. Susumu Shiomi, Third Department of Internal Medicine, Osaka City University Medical School, 1-5-7 Asahimachi, Abeno-ku, Osaka 545, Japan.

ABSTRACT

A 70-yr-old man diagnosed with situs inversus was hospitalized because of hepatic encephalopathy. Per rectal portal scintigraphy showed portal hypertension and a region with high radionuclide activity in the right lateral region of the abdomen. In percutaneous transhepatic portograms, a giant portacaval shunt was seen in the region with high radionuclide activity. After the portacaval shunt was obstructed surgically, the hepatic encephalopathy disappeared. In per rectal portal scintigraphy done 2 wk after surgery, the pattern was normal and the region with high radionuclide activity had disappeared.