Rogopoulos A, Gavelli A, Sakai H, McNamara M, Huguet C
Department of Radiology, Institut Arnault Tzanck, Saint Laurent du Var, France.
Arch Surg. 1995 Feb;130(2):227-8. doi: 10.1001/archsurg.1995.01430020117024.
A case of acute Budd-Chiari syndrome in a 26-year-old woman is reported. After a mesocaval shunt, the patient remained asymptomatic for 21 months, but ascites and hepatomegaly reappeared due to inferior vena cava stenosis subsequently treated by balloon dilation. Recurrence of stenosis indicated the need for a cavoatrial shunt with an expanded polytetrafluoroethylene prosthesis, which was followed by a complete recovery during the next 29 months. Radiological follow-up with magnetic resonance imaging demonstrated progressive hepatomegaly, thrombosis of the cavoatrial shunt, and stenosis of the mesocaval shunt. A transjugular intrahepatic portosystemic shunt was carried out, despite the absence of any patent residual hepatic vein at the usual level, by perforating the inferior vena cava and liver up to the right portal vein. An expandable 12-mm stent was successful in decreasing liver congestion. Dilation of the transjugular intrahepatic portosystemic shunt was done 15 months later, and the patient remains asymptomatic after a follow-up of 18 months.
报告了一例26岁女性急性布加综合征病例。在进行门腔分流术后，患者21个月无症状，但随后因下腔静脉狭窄出现腹水和肝肿大，通过球囊扩张进行了治疗。狭窄复发表明需要使用膨体聚四氟乙烯假体进行腔房分流，随后在接下来的29个月中完全康复。磁共振成像的放射学随访显示肝脏进行性肿大、腔房分流血栓形成和门腔分流狭窄。尽管在通常水平没有任何通畅的残余肝静脉，但通过穿刺下腔静脉和肝脏直至右门静脉进行了经颈静脉肝内门体分流术。一个12毫米可扩张支架成功减轻了肝脏淤血。15个月后对经颈静脉肝内门体分流术进行了扩张，随访18个月后患者仍无症状。
