Hepatic Myelopathy Improved by Embolization of Spontaneous Portosystemic Shunt and Partial Splenic Artery Embolization-A Case Report and Literature Review

Hepatic myelopathy (HM) is a serious and debilitating complication associated with chronic liver disease. Currently, there is no definitive treatment; however, it is widely accepted that early liver transplantation and stent-restricted surgery may alleviate HM to some extent. We report a case of an adult male with a history of hepatitis B cirrhosis who developed a complex spontaneous shunt following portal vein occlusion, which resulted in recurrent hepatic encephalopathy and was later complicated by HM. We successfully relieved HM in this patient through embolization of the inferior mesenteric venous shunt and a portion of the splenic artery. This approach may offer a feasible alternative in selected patients not eligible for liver transplantation.