Pradere B, Gédéon A, Bloom E, Concina D, Vinel J P, Fajadet P, Voigt J J, Gouzi J L
Service de Chirurgie générale et digestive, C.H.U. Purpan, Toulouse.
Chirurgie. 1990;116(2):123-9.
Two new cases of Budd-Chiari syndrome associated with thrombosis of the inferior vena cava are reported. The predominant clinical sign was ascites, and the diagnosis was suggested by ultrasound and confirmed by angiography and the imaging techniques. In one case, the etiological assessment revealed an association with an oral contraceptive treatment; the etiological research remained negative in the other case. A mesenterico-atrial shunt was performed in both patients, and its patency was controlled with magnetic resonance imaging: both shunts are functional after 38 and 45 months respectively. On the basis of these two cases, the diagnostic process, the surgical indications and the choice of the techniques are discussed. The mesenterico-atrial shunt described by Cameron and Maddrey in 1978 seems to be an interesting and reliable therapeutic choice for the Budd-Chiari syndrome with thrombosis of the inferior vena cava.
报告了两例与下腔静脉血栓形成相关的布加综合征新病例。主要临床体征为腹水，超声提示诊断，血管造影及影像学技术确诊。其中一例病因评估显示与口服避孕药治疗有关；另一例病因研究结果为阴性。两名患者均接受了肠系膜-心房分流术，通过磁共振成像监测分流管通畅情况：分别在38个月和45个月后，两个分流管均功能良好。基于这两例病例，讨论了诊断过程、手术指征及技术选择。1978年卡梅隆和马德雷描述的肠系膜-心房分流术似乎是治疗伴有下腔静脉血栓形成的布加综合征的一种有趣且可靠的治疗选择。
