Ding Peng-Xu, Li Zhen, Han Xin-Wei, Zhang Wen-Guang, Zhou Peng-Li, Wang Zhong-Gao
Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Ann Vasc Surg. 2014 Apr;28(3):742.e1-4. doi: 10.1016/j.avsg.2013.06.031. Epub 2013 Oct 24.
Budd-Chiari syndrome (BCS) caused by hepatic venous outflow obstruction may result in portal hypertension and the development of intrahepatic collaterals that bypass the obstruction. Spontaneous intrahepatic portosystemic venous shunt (SIPSVS) is uncommon and may be associated with portal hypertension. SIPSVS is extremely rare in patients with BCS and has not been well documented. We report a case of SIPSVS in a 42-year-old woman with BCS caused by membranous obstruction and chronic thrombosis in the inferior vena cava (IVC). A direct vascular communication between the left portal vein and IVC was confirmed by sonography and a computed tomography angiography scan. The patient underwent successful percutaneous balloon angioplasty of the IVC. Surgical or endovascular treatment for SIPSVS was not carried out because the patient was asymptomatic and remained asymptomatic in terms of encephalopathy at a 1-year follow-up.
由肝静脉流出道梗阻引起的布加综合征（BCS）可能导致门静脉高压以及绕过梗阻的肝内分流形成。自发性肝内门体静脉分流（SIPSVS）并不常见，且可能与门静脉高压相关。SIPSVS在BCS患者中极为罕见，相关记录也不完善。我们报告一例42岁患有BCS的女性病例，其病因是下腔静脉（IVC）的膜性梗阻和慢性血栓形成。超声检查和计算机断层血管造影扫描证实左门静脉与IVC之间存在直接的血管交通。该患者接受了IVC的经皮球囊血管成形术，手术成功。由于患者无症状，且在1年随访期内未出现肝性脑病症状，因此未对SIPSVS进行手术或血管内治疗。
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