Ohnishi K, Saito M, Saito M, Terabayashi H, Okuda K
Am J Gastroenterol. 1985 Jan;80(1):60-3.
Extensive intrahepatic portal-hepatic venous anastomosis is very rare. This report describes a 47-year-old man with cirrhosis who presented with mental confusion and flapping tremor, and in whom percutaneous transhepatic portography and superior mesenteric angiography demonstrated shunting between the portal vein branches and the right hepatic vein. Measurements of pressure, ammonia, and immunoreactive insulin in blood of the portal and right hepatic veins clearly indicated that a large amount of portal vein blood was being shunted into the right hepatic vein. These findings suggest that hepatic encephalopathy in this patient is accounted for at least in part by an intrahepatic portal-hepatic venous shunting.
广泛的肝内门静脉-肝静脉吻合非常罕见。本报告描述了一名47岁的肝硬化男性，他出现精神错乱和扑翼样震颤，经皮经肝门静脉造影和肠系膜上动脉造影显示门静脉分支与右肝静脉之间存在分流。门静脉和右肝静脉血液中的压力、氨及免疫反应性胰岛素测量结果清楚地表明，大量门静脉血正分流至右肝静脉。这些发现提示，该患者的肝性脑病至少部分是由肝内门静脉-肝静脉分流所致。
