Gottesman L, Turnbull A D, O'Reilly R J
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
J Surg Oncol. 1988 Feb;37(2):113-5. doi: 10.1002/jso.2930370210.
Hepatic venocclusive disease occurs with a spectrum of severity in an estimated 21% of bone marrow transplant patients. Clinical features include severe right upper quadrant pain, ascites, weight gain and initially minimal derangement of liver function. In contrast to hepatic graft versus host disease, venocclusive disease usually occurs within the first three weeks of engraftment and in autologous grafts. Urgent surgical consultation is requested when these features are prominent enough to mimic common acute processes requiring laparotomy. This condition must be included in the differential diagnosis in order to avoid an unnecessary laparotomy in this select group of patients who are usually severely thrombocytopenic and leukopenic. Clinical diagnosis alone is very reliable.
肝静脉闭塞病在约21%的骨髓移植患者中会以一系列严重程度出现。临床特征包括严重的右上腹疼痛、腹水、体重增加以及最初肝功能的轻微紊乱。与肝移植物抗宿主病不同，静脉闭塞病通常在植入后的前三周内发生，且多见于自体移植。当这些特征足够明显，足以模拟需要剖腹手术的常见急性病症时，应紧急请求外科会诊。在这个通常严重血小板减少和白细胞减少的特定患者群体中，为避免不必要的剖腹手术，必须将这种情况纳入鉴别诊断。仅靠临床诊断是非常可靠的。
