Hashiguchi Keiichi, Yamasaki Kazufumi, Ichikawa Tatsuki, Takeshima Fuminao, Nakao Kazuhiko
Department of Internal Medicine, St. Francis Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2011 Oct;108(10):1726-34.
A 66-year-old woman with a history of alcoholic liver cirrhosis and hepatocellular carcinoma was repeatedly hospitalized for the treatment of encephalopathy. Computed tomography demonstrated a portosystemic venous shunt which continued from portal branch P7 to the right renal vein. Since pharmacotherapy for encephalopathy was ineffective, balloon-occluded retrograde transvenous obliteration (B-RTO) was performed to block the portal-renal flow. Hyperammonemia and encephalopathy improved remarkably after the procedure. Intrahepatic portosystemic venous shunt draining into the right renal vein is a rare condition. To the best of our knowledge, management of this type of shunt by B-RTO has not been previously described. We report this case accompanied by a short review of the related literature.
一名66岁女性,有酒精性肝硬化和肝细胞癌病史,因肝性脑病反复住院治疗。计算机断层扫描显示存在门体静脉分流,从门静脉分支P7延续至右肾静脉。由于肝性脑病的药物治疗无效,遂行球囊闭塞逆行经静脉闭塞术(B-RTO)以阻断门肾血流。术后高氨血症和肝性脑病明显改善。肝内门体静脉分流至右肾静脉是一种罕见情况。据我们所知,此前尚未描述过通过B-RTO治疗此类分流的情况。我们报告该病例并对相关文献进行简要综述。