Yamashita K, Tsukuda H, Mizukami Y, Ito J, Ikuta S, Kondo Y, Kinoshita H, Fujisawa Y, Imai K
Department of Internal Medicine (Section 1), Sapporo Medical University School of Medicine, Japan.
J Gastroenterol. 1997 Oct;32(5):684-8. doi: 10.1007/BF02934122.
A case of hepatic infarction with portal thrombosis is reported. A 63-year-old woman with liver cirrhosis and esophageal varices was admitted for treatment of the esophageal varices. Endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS) were performed. Two months later, she experienced right hypochondralgia and right flank pain. Serum transaminase levels were suddenly elevated, and computed tomography scans of the liver showed multiple small nodular lesions. Her condition worsened, and she died of hepatic failure. Autopsy revealed splenic and portal vein thrombosis, multiple hepatic infarction, and evidence of chronic pancreatitis. We believe that liver cirrhosis and chronic pancreatitis were the main risk factors for the portal thrombosis, and the treatment for esophageal varices appeared to have triggered the thrombosis. The hepatic infarction was caused by the portal thrombosis.
报告了一例伴有门静脉血栓形成的肝梗死病例。一名63岁患有肝硬化和食管静脉曲张的女性因食管静脉曲张入院治疗。进行了内镜下静脉曲张结扎术（EVL）和内镜注射硬化疗法（EIS）。两个月后，她出现右季肋部疼痛和右胁腹疼痛。血清转氨酶水平突然升高，肝脏计算机断层扫描显示多个小结节性病变。她的病情恶化，死于肝衰竭。尸检发现脾静脉和门静脉血栓形成、多发性肝梗死以及慢性胰腺炎的证据。我们认为肝硬化和慢性胰腺炎是门静脉血栓形成的主要危险因素，而食管静脉曲张的治疗似乎引发了血栓形成。肝梗死是由门静脉血栓形成所致。
