Warshaw A L, Jin G L, Ottinger L W
Arch Surg. 1987 Apr;122(4):410-5. doi: 10.1001/archsurg.1987.01400160036003.
While splenic vein obstruction is a well-described feature of chronic pancreatitis, analogous occlusion of the superior mesenteric and/or portal veins (SMV-PV) has not been appreciated. We present 14 instances of SMV-PV obstruction in patients with proved chronic pancreatitis without cancer. Portal hypertension was first suspected because of variceal bleeding (4/14) or unexpected varices at laparotomy (10/14). The angiographic appearance mimicked that of pancreatic cancer. The splenic vein was also occluded in eight of the 13 patients who had angiograms. The liver was normal in all 14 cases. The clinical importance of SMV-PV occlusion in chronic pancreatitis lies in (1) its presentation by variceal bleeding, (2) the probable necessity for nonshunting means of control for bleeding varices, (3) the increased difficulty of operations on the pancreas because of portal hypertension, and (4) the possible confusion with pancreatic cancer.
虽然脾静脉梗阻是慢性胰腺炎的一个广为人知的特征，但类似的肠系膜上静脉和/或门静脉（SMV-PV）闭塞却未得到重视。我们报告了14例经证实为无癌症的慢性胰腺炎患者发生SMV-PV梗阻的病例。门静脉高压最初是因静脉曲张出血（4/14）或剖腹手术时意外发现静脉曲张（10/14）而被怀疑。血管造影表现类似胰腺癌。在13例行血管造影的患者中，有8例脾静脉也闭塞。所有14例患者的肝脏均正常。慢性胰腺炎中SMV-PV闭塞的临床重要性在于：（1）其表现为静脉曲张出血；（2）控制静脉曲张出血可能需要非分流方法；（3）由于门静脉高压，胰腺手术难度增加；（4）可能与胰腺癌混淆。
