Frank J W, Kamath P S, Stanson A W
Division of Gastroenterology and Internal Medicine, Mayo Clinic Rochester, Minnesota 55905.
Mayo Clin Proc. 1994 Sep;69(9):877-81. doi: 10.1016/s0025-6196(12)61791-1.
We present a complex case of the Budd-Chiari syndrome due to thrombosis of the hepatic veins in the presence of stenosis of the left hepatic vein and membranous obstruction of the inferior vena cava. The acute thrombosis occurred after laparoscopic surgical removal of the gallbladder. Because we strongly suspected the Budd-Chiari syndrome, hepatic venography was performed. The hepatic venous outflow obstruction was relieved by angioplasty and thrombolytic therapy with use of local infusions of urokinase into the clot. We propose that angiography be performed in patients in whom the Budd-Chiari syndrome is suspected and that angioplasty and thrombolytic therapy be initiated early.
我们报告一例复杂的布加综合征，病因是左肝静脉狭窄和下腔静脉膜性梗阻并存时肝静脉血栓形成。急性血栓形成发生在腹腔镜胆囊切除术后。由于我们高度怀疑布加综合征，遂进行了肝静脉造影。通过血管成形术以及向血凝块局部注入尿激酶进行溶栓治疗，缓解了肝静脉流出道梗阻。我们建议，对于疑似布加综合征的患者应进行血管造影，并尽早开始血管成形术和溶栓治疗。
