Portosystemic encephalopathy

[Tina]

Portosystemic encephalopathy is a neuropsychiatric syndrome that can develop in patients with liver disease. It most often results from high gut protein or acute metabolic stress (eg, gastrointestinal bleeding, infection, electrolyte abnormality) in a patient with portosystemic shunting. Symptoms are mainly neuropsychiatric (eg, confusion, asterixis, coma). Diagnosis is based on clinical findings. Treatment is usually correction of the acute cause, a diet that includes vegetable protein as the primary protein source, oral lactulose , and nonabsorbable antibiotics such as rifaximin .
(See also Liver Structure and Function and Evaluation of the Patient with a Liver Disorder.)
Portosystemic encephalopathy better describes the pathophysiology than hepatic encephalopathy or hepatic coma, but all 3 terms are used interchangeably.