Jacobs P, Maze S, Tayob F, Harries-Jones E P
Acta Haematol. 1985;74(1):45-8. doi: 10.1159/000206164.
A patient with chronic myelofibrosis and massive splenomegaly developed portal hypertension with haematemesis occurring from radiologically proven oesophageal varices. Transjugular liver biopsy showed only myeloid metaplasia, and radiological evaluation of the portal vascular system was undertaken to establish a diagnosis of hyperkinetic portal hypertension as a basis for therapeutic splenectomy. The alternative and rare situation of splenic and portal vein occlusion was demonstrated and therefore removal of the spleen was not an appropriate procedure for relief of portal hypertension. The variceal bleeding was successfully controlled with injection sclerotherapy.
一名患有慢性骨髓纤维化并伴有巨大脾肿大的患者出现门静脉高压，经放射学证实的食管静脉曲张导致呕血。经颈静脉肝活检仅显示髓外化生，对门静脉系统进行放射学评估以确诊高动力性门静脉高压，作为治疗性脾切除术的依据。结果显示存在脾脏和门静脉闭塞这种罕见的替代情况，因此切除脾脏并非缓解门静脉高压的合适方法。通过注射硬化疗法成功控制了静脉曲张出血。
