Horiguchi Y, Kitano T, Imai H, Ohsuki M, Yamauchi M, Itoh M
Division of Gastroenterology, Fujita-Gakuen Health University, School of Medicine, Aichi, Japan.
Gastroenterol Jpn. 1987 Aug;22(4):496-502. doi: 10.1007/BF02773819.
Four cases of enormous shunt between portal and hepatic veins (portal-hepatic venous shunt) are reported with special reference to sonographic and portographic findings. Ultrasonography, an examination for screening, delineated a snail-like anechoic area in the liver, its connection with the portal and hepatic veins, and marked dilatation of the veins connecting with the shunt. Transarterial or percutaneous transhepatic portography, a method for definitive diagnosis, demonstrated large pooling of the contrast medium flowing from the dilated portal branch and subsequent visualization of the hepatic vein. The etiology and prognosis are unknown at present. The most likely pathogenesis for this shunt seemed to be a congenital anomaly, namely, persistence of the omphalomesenteric venous system. With recent advances in and the more frequent use of real-time ultrasonography, detection of this kind of vascular abnormality will doubtless increase.
本文报告了4例门静脉与肝静脉之间的巨大分流（门静脉-肝静脉分流）病例，并特别提及了超声和门静脉造影的检查结果。超声检查作为一种筛查手段，在肝脏中勾勒出一个蜗牛状的无回声区，其与门静脉和肝静脉的连接，以及与分流相连的静脉明显扩张。经动脉或经皮经肝门静脉造影作为一种确诊方法，显示对比剂从扩张的门静脉分支大量聚集，随后肝静脉显影。目前病因和预后尚不清楚。这种分流最可能的发病机制似乎是一种先天性异常，即卵黄囊静脉系统持续存在。随着实时超声技术的不断进步和更频繁的使用，这类血管异常的检出率无疑会增加。
