[门静脉高压症脾切除术后门静脉血栓形成：风险与处理]

[Portal venous thrombosis following splenectomy in portal hypertension: risks and management].

作者信息

von Flüe M, Rothenbühler J M, Bianchi L, Pippert H, Beglinger C, Harder F

机构信息

Departement Chirurgie, Universitätskliniken, Kantonsspital Basel.

出版信息

Schweiz Med Wochenschr. 1993 Dec 11;123(49):2309-17.

PMID:8272806

Abstract

Splenectomy intended to treat hypersplenism can, in the presence of portal hypertension (PTH), lead to extrahepatic portal and mesenteric vein thrombosis. The management of possible variceal bleeding in patients with extrahepatic portal vein occlusion following splenectomy in portal hypertension is a problematic and challenging undertaking. We report on the management of variceal bleeding in 2 noncirrhotic patients with PTH who developed portal vein thrombosis following ill-advised splenectomy. It must be stressed again that splenectomy alone intended to control hypersplenism in portal hypertension is to be avoided at all costs. Options for the treatment of portal and mesenteric vein thrombosis and variceal bleeding are proposed.

摘要

旨在治疗脾功能亢进的脾切除术，在存在门静脉高压（PTH）的情况下，可能导致肝外门静脉和肠系膜静脉血栓形成。门静脉高压患者脾切除术后发生肝外门静脉闭塞时，处理可能出现的静脉曲张出血是一项棘手且具有挑战性的任务。我们报告了2例非肝硬化门静脉高压患者在不当脾切除术后发生门静脉血栓形成时静脉曲张出血的处理情况。必须再次强调，应不惜一切代价避免仅为控制门静脉高压患者的脾功能亢进而行脾切除术。文中提出了门静脉和肠系膜静脉血栓形成及静脉曲张出血的治疗选择。