A. Yadav1, S. K. Yadav2, A.
Srivastava3, S. K. Yachha3, M. A. Thomas4,
V. A. Saraswat, R. K. Gupta1
1Departments of
Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical
Sciences, Lucknow, India, Lucknow, UP,
India; 2Departments of Radiodiagnosis, Sanjay Gandhi Post Graduate
Institute of Medical Sciences,
Lucknow, India, lucknow, UP, India; 3Pediatric
Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical
Sciences, Lucknow, India, lucknow, UP,
India; 4Department of Radiological Sciences, David Geffen School
of Medicine at UCLA, California, California, Los Angels, United States
Minimal hepatic encephalopathy has been reported in extrahepatic portal venous obstruction patients, it is well established in cirrhotic patients. Proinflammatory cytokines and hyperammonemia play very important role in the pathogenesis of minimal hepatic encephalopathy in these patients. In extrahepatic portal venous obstruction, there is hyperammonemia and inflammation as evident by higher blood ammonia, TNF-α and IL6 levels. Significant correlation of blood ammonia, brain Glx, and mean diffusivity in various brain regions with pro-inflammatory cytokines suggests that both hyperammonemia and proinflammatory cytokines play a role in pathogenesis of cerebral edema leading to minimal hepatic encephalopathy in extrahepatic portal venous obstruction
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