Suzuki I, Nishizawa T, Kobayashi J, Shiramatsu K, Terashima M, Takazawa H
Department of Surgery and Pathology, National Chiba Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1989 May;90(5):721-5.
A case with the Budd-Chiari syndrome due to the right hepatic occlusion who was successfully operated by using the internal shunt tube of the inferior vena cava was reported. The patients was 33 year old male. Midsternal incision and right subcostal oblique incision were made and the internal shunt tube was inserted through the right auricle to the inferior vena cava. The hepatic vein was approached through the longitudinal suprahepatic caval venotomy. Then membranous obstruction in the right hepatic vein ostia was resected. Mesenteric venous pressure dropped immediately from 360mm H2O to 160mm H2O by direct manometry. All the blood bled from the right hepatic vein was transfused through the internal shunt tube to the right atrium. The patient tolerated the procedure and his postoperative course was free from the complication. The resected membrane was congenital anomaly and an operative liver biopsy was demonstrated the evidence of congestive liver with fibrosis.
报告了一例因右肝静脉闭塞导致布-加综合征的病例，该患者通过使用下腔静脉内分流管成功接受了手术。患者为33岁男性。采用胸骨正中切口和右肋下斜切口，通过右心耳将内分流管插入下腔静脉。经肝上下腔静脉纵行切开术显露肝静脉。然后切除右肝静脉开口处的膜性梗阻。通过直接测压，肠系膜静脉压力立即从360mmH₂O降至160mmH₂O。从右肝静脉流出的所有血液通过内分流管输入右心房。患者耐受了该手术，术后过程无并发症。切除的膜为先天性异常，手术肝活检显示有充血性肝伴纤维化的证据。
