Ohta M, Shimada T, Matsufuji H, Yukizane T, Yamada H, Sugimachi K
Department of Surgery II, Kyushu University, Fukuoka, Japan.
Hepatogastroenterology. 2001 Sep-Oct;48(41):1461-3.
Idiopathic portal hypertension is clinically characterized by splenomegaly and portal hypertension. Hepatic encephalopathy is rare in cases with idiopathic portal hypertension. In a 59-year-old man with recurrent hepatic encephalopathy for one year, a large splenorenal shunt was detected in the computed tomography and angiography, and liver biopsy revealed a portal fibrosis consistent with idiopathic portal hypertension. Devascularization of the upper stomach, splenectomy and closure of the splenorenal shunt were done. The patient has had no experience of encephalopathy since the operation even without drug treatment. Surgery should be considered for treatment of chronic hepatic encephalopathy in patients with idiopathic portal hypertension and portosystemic shunts.
特发性门静脉高压症的临床特征为脾肿大和门静脉高压。肝性脑病在特发性门静脉高压症患者中较为罕见。在一名患有复发性肝性脑病一年的59岁男性患者中，计算机断层扫描和血管造影检查发现了一个巨大的脾肾分流，肝活检显示门静脉纤维化符合特发性门静脉高压症。进行了胃上部去血管化、脾切除术和脾肾分流闭合术。术后即使未进行药物治疗，患者也未再出现肝性脑病。对于患有特发性门静脉高压症和门体分流的慢性肝性脑病患者，应考虑手术治疗。
