Ohmoto K, Miyake I, Tsuduki M, Ohno S, Yamamoto S
Department of Medicine, Kawasaki Medical School, Okayama, Japan.
Hepatogastroenterology. 1999 Mar-Apr;46(26):1249-52.
In a patient with liver cirrhosis complicated by solitary gastric fundal varices and portosystemic encephalopathy, Balloon-occluded retrograde transvenous obliteration (B-RTO) of the varices was performed. The gastric varices were decreased in size 2 weeks after treatment and had not recurred after 1 year. B-RTO successfully occluded the portosystemic shunt (gastrorenal shunt). Accordingly, the patient's blood ammonia levels, total bile acid level, and 15 min retention rate of indocyanine green decreased, and his hepatic encephalopathy improved. However, since consecutive increase in blood flow through the portal collateral vessels except for gastrorenal shunt vessel at 6 months and 1 year after B-RTO was noted, further careful follow-up may be required.
在一名患有肝硬化并伴有孤立性胃底静脉曲张和门体性脑病的患者中，对静脉曲张进行了球囊闭塞逆行静脉栓塞术（B-RTO）。治疗2周后胃静脉曲张尺寸减小，1年后未复发。B-RTO成功闭塞了门体分流（胃肾分流）。因此，患者的血氨水平、总胆汁酸水平以及吲哚菁绿15分钟潴留率降低，肝性脑病得到改善。然而，由于在B-RTO术后6个月和1年时，除胃肾分流血管外的门静脉侧支血管血流量持续增加，可能需要进一步密切随访。
