Department of Urology, China Medical University Hospital, Taichung, Taiwan.
Kaohsiung J Med Sci. 2009 Dec;25(12):669-74. doi: 10.1016/S1607-551X(09)70573-X.
Portosystemic shunts frequently develop in patients with cirrhosis. However, congenital splenorenal shunts are rare anomalies in people without portal hypertension. Here, we present a case of a venous shunt between the spleen and left renal vein in a 57-year-old man with no history of liver cirrhosis, portal hypertension, or hepatic encephalopathy. The abnormal vessel was identified on preoperative contrast-enhanced computed tomography performed for diagnosis of a left adrenal aldosterone-producing adenoma. The shunt was safely ligated during transperitoneal laparoscopic left adrenalectomy. Excessive bleeding due to accidental injury of the shunting vessel during the procedure is a likely complication. Careful review of preoperative computed tomography images and cautious management of this type of shunt, especially in cirrhotic patients, can prevent this serious complication.
门体分流在肝硬化患者中经常发生。然而，在没有门静脉高压的人群中，先天性脾肾分流是一种罕见的异常。在这里，我们介绍了一例 57 岁男性的静脉分流，该患者无肝硬化、门静脉高压或肝性脑病病史。在为诊断左肾上腺醛固酮瘤而行术前增强 CT 检查时发现了异常血管。在经腹腔腹腔镜左肾上腺切除术期间安全地结扎了分流。在手术过程中意外损伤分流血管导致的过度出血是一种可能的并发症。仔细审查术前 CT 图像并谨慎处理此类分流，特别是在肝硬化患者中，可以预防这种严重并发症。
