Bail J P, Andivot T, Leal T, Menut P, Nousbaum J B, Charles J F
Service de Chirurgie digestive et endocrinienne Bichat V, CHRU Morvan, Brest.
Ann Chir. 1993;47(1):47-51.
In chronic pancreatitis (CP) portal vein thrombosis (PT) is a less well known complication than splenic vein thrombosis (ST). In the literature up until 1990, 26 cases with PT, have been reported and only 10 cases presented a isolated PT, without ST. We report a new case of isolated PT without ST in a non alcoholic man, who presented with gastroesophageal CP and a cavernomatous transformation of the portal vein. No varices ere detected by endoscopy; because the risk of bleeding was very small, a prophylactic treatment was unnecessary. The pancreas was resected preserving the spleen and cavernomatous transformation or the periportal veins and the patient was cured from his pains. The surgical tactic is an original treatment, particularly when curable pancreatic cancer is suspected.
在慢性胰腺炎(CP)中,门静脉血栓形成(PT)是一种比脾静脉血栓形成(ST)鲜为人知的并发症。截至1990年的文献中,已报道26例PT病例,仅有10例为孤立性PT,无ST。我们报告1例非酒精性男性患者的孤立性PT且无ST的新病例,该患者患有胃食管CP及门静脉海绵样变性。内镜检查未发现静脉曲张;由于出血风险非常小,无需进行预防性治疗。切除胰腺时保留脾脏以及门静脉周围的海绵样变性,患者疼痛得以治愈。这种手术策略是一种原创性治疗方法,尤其在怀疑为可治愈的胰腺癌时。