Shaw Brian I, Barbas Andrew S, Sudan Debra L
Department of Surgery, Duke University, Durham, NC, USA.
Case Rep Transplant. 2020 Oct 7;2020:8863508. doi: 10.1155/2020/8863508. eCollection 2020.
Multivisceral transplantation is the therapy of choice in patients with diffuse portomesenteric thrombosis. In the present case, we describe a patient who had persistent ascites after multivisceral transplant. The patient was initially diagnosed with a chyle leak which was cured via embolization. When this did not cure her ascites, reexploration proved the etiology to be at least partially attributable to persistent hypertension in the retained viscera. This was cured with the resection of her native viscera. This case highlights the importance of resection of all congested viscera at the time of transplantation in patients with diffuse portomesenteric thrombosis, the utility of preoperative embolization techniques in assisting this, and also the ability to perform delayed resection if necessary.
多脏器移植是弥漫性门静脉肠系膜血栓形成患者的首选治疗方法。在本病例中，我们描述了一名多脏器移植后持续腹水的患者。该患者最初被诊断为乳糜漏，通过栓塞治愈。当这并未治愈她的腹水时，再次探查证明病因至少部分归因于保留脏器中的持续性高血压。通过切除其原有的脏器治愈了这种情况。该病例强调了在弥漫性门静脉肠系膜血栓形成患者移植时切除所有充血脏器的重要性、术前栓塞技术在辅助这一过程中的作用，以及在必要时进行延迟切除的能力。
