Nagano K, Hoshino H, Nishimura D, Katada N, Sano H, Kato K
Department of Internal Medicine, Kamo Hospital, Toyota, Aichi, Japan.
J Gastroenterol Hepatol. 1999 Mar;14(3):285-8. doi: 10.1046/j.1440-1746.1999.01848.x.
Patent ductus venosus is extremely rare with only 14 cases reported in the world literature. We present a case of patent ductus venosus.
A 29-year-old male was admitted with melaena stool caused by gastric haemorrhagic ulcers. Laboratory data disclosed severe anaemia; however, liver function tests were normal. Serum ammonia was also within the normal range. Serological viral markers for hepatitis B or C were all negative. The abdominal ultrasonography and computed tomography indicated a 12 mm diameter shunt located in the left lobe of the liver, which connected the portal vein with the left hepatic vein. After treatment for gastric ulcers, percutaneous transhepatic portography was performed and an enormous shunt connecting the umbilical portion of the portal vein with the left hepatic vein was revealed.
Histological findings of the liver biopsy showed that portal venules could not be observed in the portal areas and that no fibrosis or inflammatory cell infiltration were shown. Because of the anatomical position of the shunt, the case was diagnosed as patent ductus venosus.
静脉导管未闭极为罕见,世界文献中仅报道过14例。我们现报告一例静脉导管未闭病例。
一名29岁男性因胃出血性溃疡导致黑便入院。实验室检查显示严重贫血;然而,肝功能检查正常。血清氨水平也在正常范围内。乙肝或丙肝血清学病毒标志物均为阴性。腹部超声和计算机断层扫描显示肝脏左叶有一个直径12毫米的分流,连接门静脉和左肝静脉。治疗胃溃疡后,进行了经皮肝门静脉造影,发现一个巨大的分流,连接门静脉脐部和左肝静脉。
肝脏活检的组织学检查结果显示,门静脉区域未观察到门静脉小分支,也未显示纤维化或炎性细胞浸润。由于分流的解剖位置,该病例被诊断为静脉导管未闭。