Hashimoto Naotaka, Akahoshi Tomohiko, Shoji Tetsuya, Tomikawa Morimasa, Tsutsumi Norifumi, Yoshizumi Tomoharu, Taketomi Akinobu, Shirabe Ken, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
Case Rep Gastroenterol. 2011;5(2):366-71. doi: 10.1159/000330287. Epub 2011 Jul 8.
This report presents the case of a 78-year-old female with hepatic encephalopathy due to an inferior mesenteric venous-inferior vena cava shunt. She developed hepatocellular carcinoma affected by hepatitis C virus-related cirrhosis and underwent posterior sectionectomy. Portal vein thrombosis developed and the portal trunk was narrowed after hepatectomy. Portal vein thrombosis resulted in high portal pressure and increased blood flow in an inferior mesenteric venous-inferior vena cava shunt, and hepatic encephalopathy with hyperammonemia was aggravated. The hepatic encephalopathy aggravated by portal vein thrombosis was successfully treated by balloon-occluded retrograde transvenous obliteration via a right transjugular venous approach without the development of other collateral vessels.
本报告介绍了一例78岁女性因肠系膜下静脉-下腔静脉分流导致肝性脑病的病例。她患有丙型肝炎病毒相关肝硬化所致的肝细胞癌，并接受了肝后段切除术。肝切除术后发生门静脉血栓形成，门静脉主干变窄。门静脉血栓形成导致门静脉高压升高，肠系膜下静脉-下腔静脉分流处血流增加，伴有高氨血症的肝性脑病加重。通过经右颈静脉途径进行球囊闭塞逆行静脉闭塞术成功治疗了由门静脉血栓形成加重的肝性脑病，且未形成其他侧支血管。
