Sanampudi Sreeja, Raissi Driss
University of Kentucky College of Medicine, Hospital Radiology, 800 Rose St., Lexington, KY 40536, USA.
University of Kentucky, Hospital Radiology, 800 Rose St., Lexington, KY 40536, USA.
Radiol Case Rep. 2018 Aug 7;13(5):975-981. doi: 10.1016/j.radcr.2018.06.010. eCollection 2018 Oct.
Portal venous embolization (PVE) is a well-validated technique to promote contralateral liver lobe hypertrophy prior to hepatic resection. We present a case of a patient with Type IV cholangiocarcinoma undergoing PVE prior to hepatic surgical resection. However, intrahepatic portal-venous shunts were incidentally found during the procedure and were subsequently embolized using embolic coils and N-butyl cyanoacrylate. While most patients with congenital portal-venous shunts remain asymptomatic, an unrecognized shunt during PVE could have resulted in a devastating complication secondary to nontarget embolization through the fistula. To our knowledge, this is the first reported case of a portal-venous shunt being discovered during a PVE.
门静脉栓塞术（PVE）是一种在肝切除术前促进对侧肝叶肥大的经过充分验证的技术。我们报告一例IV型胆管癌患者在肝脏手术切除前接受PVE的病例。然而，术中偶然发现肝内门静脉分流，随后使用栓塞弹簧圈和氰基丙烯酸正丁酯进行栓塞。虽然大多数先天性门静脉分流患者无症状，但PVE期间未识别的分流可能导致通过瘘管进行非靶栓塞继发的灾难性并发症。据我们所知，这是首例在PVE期间发现门静脉分流的报道病例。
