Onitsuka A, Katagiri Y, Shibata M, Hirose H, Shimazaki M
First Department of Surgery, Gifu University School of Medicine.
Hepatogastroenterology. 1997 Sep-Oct;44(17):1324-7.
A case of 48-year-old man, with diffuse arterioportal fistula (APF) considered congenital in origin, is described. The patient presented with recurring intractable variceal hemorrhage which was treated by endoscopic ligation or sclerotherapy. In this case, gastroduodenal artery and branches of mesenterial artery were diffusely involved, so these lesions could not be resected. Portocaval shunt between the superior mesenteric vein and the right iliac vein was successfully performed. Follow-up endoscopic examination one year later revealed no evidence of esophageal and gastric varices. To our knowledge, this is the second case in which a patient underwent portocaval shunt successfully for congenital APF.
本文描述了一例48岁男性患者，患有起源于先天性的弥漫性动门静脉瘘（APF）。该患者反复出现难以治疗的静脉曲张出血，通过内镜结扎或硬化疗法进行治疗。在本病例中，胃十二指肠动脉和肠系膜动脉分支广泛受累，因此这些病变无法切除。成功实施了肠系膜上静脉与右髂静脉之间的门腔分流术。一年后的随访内镜检查显示没有食管和胃静脉曲张的迹象。据我们所知，这是第二例因先天性APF成功接受门腔分流术的患者。
