Liver Foundation Nepal, Kathmandu, Nepal.
Hepatol Res. 2007 Mar;37(3):196-204. doi: 10.1111/j.1872-034X.2007.00012.x.
Hepatic vena cava disease is a primary obliterative disease of the hepatic portion of the inferior vena cava (IVC) that often causes liver cirrhosis and hepatocellular carcinoma. Its geographic prevalence is inversely related to the standard of community hygiene. The disease is endemic in Nepal and is commonly associated with bacterial infection. The cause of the disease is not known. It was previously thought to be congenital. Thrombosis due to hypercoagulable condition is suggested as a possible cause of the disease. This study looks at the relation of the disease to bacterial infection.
Ultrasonography is sensitive and specific for the diagnosis of acute and chronic lesions of hepatic vena cava disease. Patients attending the Liver Clinic with pyrexia with and without bacteremia were examined by ultrasonography for acute "thrombophlebitic" lesion of the IVC, and five patients with bacterial infection with acute lesion in the hepatic portion of the IVC were followed.
Sixty eight percent of the patients with bacteremia had ultrasonographic evidence of acute lesion in the hepatic portion of the IVC, compared to 18% patients without bacteremia. A follow-up study of five patients showed transformation of the acute lesion into chronic obliterative lesion - stenosis or complete obstruction.
Bacterial infection is probably the cause of hepatic vena cava disease seen in developing countries.
肝静脉疾病是肝下段下腔静脉（IVC）的原发性闭塞性疾病，常导致肝硬化和肝细胞癌。其地理流行率与社区卫生标准成反比。该病在尼泊尔流行，通常与细菌感染有关。病因不明。以前认为是先天性的。高凝状态引起的血栓形成被认为是该病的可能原因。本研究探讨了该病与细菌感染的关系。
超声检查对肝静脉疾病的急性和慢性病变具有高度敏感性和特异性。在肝脏科就诊的发热伴或不伴菌血症患者均行超声检查，以诊断 IVC 急性“血栓性静脉炎”病变，对 5 例伴有 IVC 肝段急性病变的细菌感染者进行了随访。
菌血症患者中有 68%超声检查显示 IVC 肝段有急性病变，而无菌血症患者为 18%。对 5 例患者的随访研究显示，急性病变转化为慢性闭塞性病变——狭窄或完全阻塞。
细菌感染可能是发展中国家所见肝静脉疾病的病因。
