经Retzius分流术治疗直肠癌：一例报告
Surgical treatment of rectal cancer with a Retzius shunt: a case report.
作者信息
Sueda Toshinori, Tei Mitsuyoshi, Furukawa Haruna, Matsumura Tae, Koga Chikato, Wakasugi Masaki, Miyagaki Hiromichi, Kawabata Ryohei, Shimizu Junzo, Okada Atsuya, Hasegawa Junichi
机构信息
Department of Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kita-ku, Sakai, 591-8025, Japan.
Department of Diagnostic and Interventional Radiology, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kita-ku, Sakai, 591-8025, Japan.
出版信息
Surg Case Rep. 2019 Feb 18;5(1):25. doi: 10.1186/s40792-019-0583-z.
BACKGROUND
A case of a short circuit (Retzius shunt) from the inferior mesenteric vein (IMV) to the inferior vena cava (IVC) without accompanying portal hypertension due to liver cirrhosis is rare.
CASE PRESENTATION
An 83-year-old woman who was followed after surgery for thyroid and breast cancer was incidentally found to have rectal cancer on computed tomography (CT). Preoperative three-dimensional CT showed a venous malformation forming a short circuit (Retzius shunt) from the IMV to the IVC. Laparoscopic anterior rectal resection was performed. Operative findings included the Retzius vein crossing the abdominal aorta and the inferior mesenteric artery (IMA) to the IVC and a number of engorged vessels in the mesentery. The Retzius vein and IMA were clipped without major bleeding, and tumor-specific mesorectal excision was then performed. The patient's postoperative clinical course was good, and she was discharged without complications.
CONCLUSIONS
Preoperative imaging enabled identification of an unexpected rare disease, thus reinforcing the importance of preoperative imaging.
背景
肠系膜下静脉（IMV）至下腔静脉（IVC）形成短路（雷济厄斯分流）且无肝硬化所致门静脉高压的病例罕见。
病例介绍
一名83岁女性，因甲状腺癌和乳腺癌手术后接受随访，在计算机断层扫描（CT）检查时偶然发现患有直肠癌。术前三维CT显示静脉畸形，形成了从IMV至IVC的短路（雷济厄斯分流）。进行了腹腔镜前直肠切除术。手术所见包括雷济厄斯静脉穿过腹主动脉和肠系膜下动脉（IMA）至IVC，以及肠系膜内大量充血血管。在无大出血情况下夹闭雷济厄斯静脉和IMA，然后进行肿瘤特异性直肠系膜切除术。患者术后临床过程良好，无并发症出院。
结论
术前影像学检查能够识别出意外的罕见疾病，从而强化了术前影像学检查的重要性。
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