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肝移植挽救:经颈静脉肝内门体分流术(TIPSS)及血栓切除术成功治疗一例合并门静脉血栓形成的急性布加综合征

Rescue from liver transplantation: TIPSS and thrombectomy successfully treat a case of acute Budd-Chiari syndrome complicated by portal vein thrombosis.

作者信息

Townsend Sarah A, Karkhanis Salil, Tripathi Dhiraj, Mueisan Paolo, Zia Zergham, Elsharkawy Ahmed M

机构信息

Liver Unit, Queen Elizabeth Hospital, Birmingham, UK.

Radiology Department, Queen Elizabeth Hospital, Birmingham, UK.

出版信息

BJR Case Rep. 2016 Jul 27;3(1):20160059. doi: 10.1259/bjrcr.20160059. eCollection 2017.

Abstract

We report the rare case of a female who presented with fulminant liver failure secondary to acute Budd-Chiari syndrome and complete portal vein thrombosis. She met the criterion for liver transplant and was transferred to our care for assessment and further management. Transplant was deemed a too-high risk and so rescue therapy was undertaken using mechanical thrombectomy and transjugular intrahepatic portosystemic shunt insertion to decompress the portal system. The patient made a full recovery. This is a rare case report of a patient meeting liver transplant criteria secondary to acute Budd-Chiari syndrome and complete portal vein thrombosis, which was managed successfully entirely by radiological means; this technique could be used to avoid or act as a bridge to liver transplantation in the future.

摘要

我们报告了一例罕见病例,一名女性因急性布加综合征继发暴发性肝衰竭并伴有完全门静脉血栓形成。她符合肝移植标准,被转至我们处进行评估和进一步治疗。移植被认为风险过高,因此采用机械血栓切除术和经颈静脉肝内门体分流术进行抢救治疗,以减压门静脉系统。患者完全康复。这是一例罕见病例报告,该患者因急性布加综合征和完全门静脉血栓形成符合肝移植标准,但完全通过放射学方法成功治疗;该技术未来可用于避免肝移植或作为肝移植的桥梁。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bc6/6159308/4d0cb74d5e1e/bjrcr.20160059.g001.jpg

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