Department of Surgery, Children's Memorial Hospital, Feinberg School of Medicine of Northwestern University, Box 57, Chicago, IL 60614, USA.
Department of Surgery, Children's Memorial Hospital, Feinberg School of Medicine of Northwestern University, Box 57, Chicago, IL 60614, USA.
J Pediatr Surg. 2011 Apr;46(4):749-752. doi: 10.1016/j.jpedsurg.2010.12.017.
A 3-year-old girl with idiopathic extrahepatic portal vein obstruction undergoing mesenterico-left portal vein bypass (MLPVB), or Rex shunt, for recurrent variceal bleeding was intraoperatively discovered to have duplicated round ligaments and Rex recessi. The left and right portal veins connected to their respective round ligaments but had minimal communication within the liver. Intraoperative venography identified a better preserved portal system on the left, and standard MLPVB resulted in excellent shunt flow. The shunt remains patent and the patient asymptomatic 9 months after her operation. Abnormal portal anatomy is not a contraindication to MLPVB.
一名 3 岁女孩因特发性肝外门静脉阻塞，接受肠系膜-左门静脉分流术（MLPVB）或雷克斯分流术，以治疗复发性静脉曲张出血，术中发现存在双圆韧带和雷克斯陷凹。左、右门静脉分别与各自的圆韧带相连，但在肝脏内沟通甚少。术中门静脉造影显示左侧门静脉系统保存较好，标准的 MLPVB 导致了良好的分流血流。分流术保持通畅，患者术后 9 个月无症状。异常的门静脉解剖结构不是 MLPVB 的禁忌证。
