经门静脉动脉瘤形成的门静脉-肝静脉分流，并发肝性脑病和肺动脉高压。

Portal-hepatic venous shunt through a portal aneurysm complicated by hepatic encephalopathy and pulmonary hypertension.

作者信息

Hondo T, Teragawa H, Munemori M, Morishima N, Watanabe H, Ogata S, Ohe H, Yoshikawa M, Ohbayashi M

机构信息

Department of Internal Medicine, Onomichi General Hospital, Hiroshima.

出版信息

Intern Med. 1997 Nov;36(11):790-3. doi: 10.2169/internalmedicine.36.790.

DOI:10.2169/internalmedicine.36.790

PMID:9392351

Abstract

We report a rare case of portal-hepatic venous shunt through an enormous portal aneurysm complicated by pulmonary hypertension. A 66-year-old woman was admitted to our hospital for hepatic encephalopathy. Chest roentgenography revealed pulmonary hypertension. Computed tomography and ultrasound examination demonstrated a shunt between the portal and hepatic veins through an enormous portal aneurysm. The diagnoses of portal-hepatic venous shunt and pulmonary hypertension were confirmed by hepatic venous catheterization and cardiac catheterization. Pulmonary hypertension might result from the effects of vasoconstrictive agents, which should be metabolized by the liver in normal subjects, passing through the intrahepatic shunt into the lung.

摘要

我们报告了一例罕见的通过巨大门静脉瘤形成门静脉-肝静脉分流并伴有肺动脉高压的病例。一名66岁女性因肝性脑病入住我院。胸部X线检查显示有肺动脉高压。计算机断层扫描和超声检查显示通过一个巨大的门静脉瘤存在门静脉和肝静脉之间的分流。通过肝静脉插管和心导管检查证实了门静脉-肝静脉分流和肺动脉高压的诊断。肺动脉高压可能是由于血管收缩剂的作用导致的，在正常情况下这些血管收缩剂应由肝脏代谢，而现在却通过肝内分流进入了肺部。