Cappelle Marie, Douchy Thomas, Vanbeckevoort Dirk, Fourneau Inge, Barriga Mauricio Sainz, Pirenne Jacques
Abdominal Transplant Surgery & Coordination, University Hospitals, Leuven, Belgium.
Infectiology and Transplantation Department, University Hospitals, Leuven, Belgium.
J Vasc Surg Cases Innov Tech. 2020 Sep 2;6(4):562-565. doi: 10.1016/j.jvscit.2020.08.015. eCollection 2020 Dec.
Surgical shunt therapy may be required when pharmacologic, endoscopic, and radiologic treatment of chronic splanchnic vein thrombosis have failed. In this case report, we present a new interposition shunt for the treatment of refractory rectal variceal bleeding: the inferior mesoiliacal shunt between the inferior mesenteric vein and the left common iliac vein using a cryopreserved iliac venous graft. The postoperative course was complicated by shunt thrombosis at day 2, probably owing to inadvertent interruption of anticoagulation and a decrease in the shunt flow rate. Surgical thrombectomy was performed successfully. The patient presented no relapse of rectal bleeding and was asymptomatic and well at the 12-month follow-up.
当慢性内脏静脉血栓形成的药物、内镜和放射治疗失败时，可能需要进行手术分流治疗。在本病例报告中，我们介绍一种用于治疗难治性直肠静脉曲张出血的新型搭桥分流术：使用冷冻保存的髂静脉移植物在肠系膜下静脉和左髂总静脉之间进行肠系膜下髂内分流术。术后病程在第2天出现分流血栓形成并发症，可能是由于抗凝的意外中断和分流流速降低所致。成功进行了手术取栓。患者直肠出血未复发，在12个月的随访中无症状且情况良好。
