Rahmani Omid, Wolpert Lorraine M, Drezner A David
Connecticut Vascular Institute, Hartford Hospital, 85 Seymour Street, Hartford, CT 06102, USA.
J Vasc Surg. 2002 Dec;36(6):1264-6. doi: 10.1067/mva.2002.129644.
Isolated intractable bleeding from anorectal varices is a rare complication of portal hypertension. We report a case of a patient with cirrhosis and hepatofugal flow who had severe lower gastrointestinal bleeding from anorectal varices. This is the first case report of construction of a distal inferior mesenteric vein shunt to left renal vein as a selective shunt for treatment of bleeding anorectal varices in a patient with hepatofugal flow. The patient is a 39-year-old white man with a medical history significant for alcohol abuse who was seen with bright red blood per rectum requiring 10 units of packed red blood cells over the course of a year. The work-up revealed anorectal varices with no other colonic lesions. The patient underwent construction of a distal inferior mesenteric vein to left renal vein shunt.
孤立性肛门直肠静脉曲张难治性出血是门静脉高压的一种罕见并发症。我们报告一例肝硬化且存在肝血流离肝的患者，该患者因肛门直肠静脉曲张出现严重的下消化道出血。这是首例关于构建肠系膜下静脉远端至左肾静脉分流术作为选择性分流术治疗肝血流离肝患者肛门直肠静脉曲张出血的病例报告。该患者为一名39岁的白人男性，有酗酒病史，因直肠鲜红色血便就诊，在一年时间里需要输注10单位的浓缩红细胞。检查发现存在肛门直肠静脉曲张，无其他结肠病变。该患者接受了肠系膜下静脉远端至左肾静脉分流术的构建。
