Nishihara Yuki, Seyama Yasuji, Takahashi Masamichi, Matsuoka Yujiro, Kudo Hiroki, Kanomata Hiroyuki, Maeshiro Tsuyoshi, Miyamoto Sachio
Department of Surgery, Tokyo Metropolitan Bokutoh Hospital.
Department of Radiology, Tokyo Metropolitan Bokutoh Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2019;116(3):249-255. doi: 10.11405/nisshoshi.116.249.
An 86-year-old male underwent pancreatoduodenectomy with resection and reconstruction of portal vein for pancreatic cancer. He was admitted to our hospital because of severe anemia and dyspnea ten months later. Computed tomography showed varices at the biliary-enteric anastomosis in the elevated jejunum caused by portal venous stenosis, which was suspected as the cause of anemia. Therefore, the patient underwent balloon dilatation of the portal vein followed by stent placement and coil embolization of the collaterals using a transileocolic portal vein approach. After the procedure, portal venous flow was improved, and the collaterals disappeared. The patient has been asymptomatic with no recurrence for three years and four months.
一名86岁男性因胰腺癌接受了胰十二指肠切除术及门静脉切除重建术。十个月后,他因严重贫血和呼吸困难入住我院。计算机断层扫描显示,由于门静脉狭窄,空肠上段胆肠吻合处出现静脉曲张,怀疑这是贫血的原因。因此,患者采用经回结肠门静脉途径进行门静脉球囊扩张,随后放置支架并对侧支进行弹簧圈栓塞。术后门静脉血流得到改善,侧支消失。患者三年零四个月来一直无症状,无复发。