Masood Irfan, Saleem Arsalan, Malik Komal, Rashidi Laila, Kathuria Manoj
Department of Radiology, University of Texas Medical Branch, Galveston, TX 77555, USA.
Dow Medical College, Karachi, Sindh 74200, Pakistan.
Radiol Case Rep. 2020 Jul 2;15(9):1423-1427. doi: 10.1016/j.radcr.2020.06.023. eCollection 2020 Sep.
Abdominal surgery in patients with cirrhosis and portal hypertension remains a challenge due to higher risk of morbidity and mortality. Preoperative elective transjugular intrahepatic portosystemic shunt (TIPS) is increasingly being used in these patient population. Herein, we report a case of 65-year-old male with biopsy-proven ascending colon cancer and cirrhosis. As a sequalae of portal hypertension, patient also had large caput medusae which posed significant challenge to the surgical approach for resection of the colon cancer. The patient was managed initially with placement of TIPS to decompress the portal pressures and caput medusae and allow safe surgical field for curative resection of the colon cancer. Following this, the patient underwent uneventful laparoscopic right hemicolectomy.
由于发病率和死亡率风险较高，肝硬化和门静脉高压患者的腹部手术仍然是一项挑战。术前选择性经颈静脉肝内门体分流术（TIPS）在这些患者群体中越来越多地被使用。在此，我们报告一例65岁男性患者，经活检证实为升结肠癌并伴有肝硬化。作为门静脉高压的后遗症，患者还患有粗大的腹壁静脉曲张，这给结肠癌切除术的手术入路带来了重大挑战。该患者最初接受了TIPS置入术，以降低门静脉压力和减轻腹壁静脉曲张，从而为结肠癌的根治性切除提供安全的手术视野。在此之后，患者顺利接受了腹腔镜右半结肠切除术。
