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经右肾静脉肝内门体静脉分流术采用球囊闭塞逆行静脉栓塞术成功治疗

[Intrahepatic portosystemic venous shunt via right renal vein successfully treated with balloon-occluded retrograde transvenous obliteration].

作者信息

Hashiguchi Keiichi, Yamasaki Kazufumi, Ichikawa Tatsuki, Takeshima Fuminao, Nakao Kazuhiko

机构信息

Department of Internal Medicine, St. Francis Hospital.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2011 Oct;108(10):1726-34.

Abstract

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.

摘要

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。

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