Maunoury V, Plane C, Ernst O, Seguy D, Quandalle P
Service des Maladies de l'Appareil Digestif, CHR de Lille.
Gastroenterol Clin Biol. 1994;18(10):889-91.
This report concerns a case of absence of caudal inferior vena cava revealed by gastrointestinal bleeding from isolated duodenal varices by an adult. The diagnosis of duodenal varices was performed by ultrasonographic endoscopy. Development of duodenal varices in absence of portal hypertension is uncommon. Involvement of cavo-portal collateral circulation in case of inferior vena cava obstruction is unusual and duodenal varices are still more rarely encountered. Diagnosis was ultimately supported by femoral venous angiography showing the absence of inferior vena cava and a venous return from the right lumbar vein into the portal vein via the duodenal varices. The absence of caudal portion of inferior vena cava is more probably related to neo-natal thrombosis than to a true atresia.
本报告涉及一名成人因孤立性十二指肠静脉曲张导致胃肠道出血而发现的下腔静脉尾段缺如病例。十二指肠静脉曲张的诊断通过超声内镜检查进行。在无门静脉高压的情况下发生十二指肠静脉曲张并不常见。下腔静脉阻塞时腔门静脉侧支循环受累情况罕见,十二指肠静脉曲张则更为少见。最终,股静脉血管造影证实了诊断,显示下腔静脉缺如,且存在从右腰静脉经十二指肠静脉曲张回流至门静脉的情况。下腔静脉尾段缺如更可能与新生儿血栓形成有关,而非真正的闭锁。