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  • Title: Recurrent hepatic pre-coma resulting from a spontaneous porto-spleno-renal shunt (PSRS).
    Author: Overdorp MJ, Tan HS, Molenaar AH, Janssen JB.
    Journal: Neth J Med; 1995 Jan; 46(1):30-5. PubMed ID: 7877710.
    Abstract:
    A 64-year-old Turkish male is described with recurrent hepatitic (pre-)coma resulting from a spontaneous porto-spleno-renal shunt, portal hypertension and hepatic insufficiency. In cases of chronic encephalopathy resulting from hepatic insufficiency that may be due to liver cirrhosis, the presence of a spontaneous porto-spleno-renal shunt should be considered as a distinct possibility, not only in the absence of apparent oesophageal varices and splenomegaly, but also when there is hepatopetal flow in the portal vein.
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