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门静脉高压伴脾肿大及门静脉海绵样变的成功管理:一例罕见病例报告

Successful management of portal hypertension with splenomegaly and cavernous transformation of the portal vein: a rare case report.

作者信息

Sharjeel Simrah, Abdullah Muhammad

机构信息

Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.

General Surgery, Indus Hospital and Health Network, Karachi, Pakistan.

出版信息

J Surg Case Rep. 2023 Dec 6;2023(12):rjad607. doi: 10.1093/jscr/rjad607. eCollection 2023 Dec.

Abstract

Portal hypertension, often stemming from liver cirrhosis or vascular anomalies, can result in cavernous transformation of the portal vein, a rare condition associated with biliary obstruction, variceal hemorrhage, and splenomegaly. This case report details a unique occurrence of portal hypertension, splenomegaly, and cavernous transformation of the portal vein successfully managed through splenectomy and spleno-renal shunt. A 30-year-old female with a history of portal hypertension, portal gastropathy, and splenomegaly presented with left upper quadrant abdominal pain. She had previously undergone esophageal variceal ligation and required intermittent blood transfusions. Additional complications included easy bruising, heavy menstrual bleeding, and a prior episode of hematemesis. Clinical assessment confirmed splenomegaly, while a CT scan confirmed the diagnosis. A tailored surgical approach was chosen, leading to splenectomy and spleno-renal shunt.

摘要

门静脉高压通常源于肝硬化或血管异常,可导致门静脉海绵样变性,这是一种与胆道梗阻、静脉曲张出血和脾肿大相关的罕见病症。本病例报告详细介绍了一例独特的门静脉高压、脾肿大和门静脉海绵样变性病例,通过脾切除术和脾肾分流术成功得到治疗。一名有门静脉高压、门静脉胃病和脾肿大病史的30岁女性出现左上腹疼痛。她此前曾接受过食管静脉曲张结扎术,需要间歇性输血。其他并发症包括容易出现瘀伤、月经过多,以及曾有一次呕血发作。临床评估证实存在脾肿大,CT扫描确诊了病情。选择了一种量身定制的手术方法,进行了脾切除术和脾肾分流术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5db/10702272/1ad94516e72f/rjad607f1.jpg

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