Nishimoto Y, Hoshino H, Sato S, Oguri A, Yamada M, Nishimura D, Katada N, Sano H, Kato K
Department of Internal Medicine, Kamo Hospital, Toyota, Aichi.
Intern Med. 1997 Dec;36(12):886-9. doi: 10.2169/internalmedicine.36.886.
A 72-year-old woman was admitted for recurrent episodes of encephalopathy. Laboratory data showed mild liver dysfunction and hyperammonemia, while she had neither anemia nor splenomegaly. The dilated inferior mesenteric vein (IMV) was opacified retrogradely from the superior mesenteric vein by superior mesenteric arteriography, and IMV was found to connect with the inferior vena cava (IVC) through a torturous shunt. No obstruction of the extrahepatic portal vein or hepatic vein was observed by arteriography. Histological evaluation of the liver biopsy indicated remarkable fatty change without cirrhosis. Finally, we diagnosed this case as extrahepatic portosystemic venous shunt without portal hypertension.
一名72岁女性因反复出现脑病发作入院。实验室检查数据显示有轻度肝功能不全和高氨血症，同时她既没有贫血也没有脾肿大。通过肠系膜上动脉造影，扩张的肠系膜下静脉（IMV）从肠系膜上静脉逆行显影，并且发现IMV通过一条迂曲的分流与下腔静脉（IVC）相连。动脉造影未观察到肝外门静脉或肝静脉梗阻。肝脏活检的组织学评估显示有明显的脂肪变性但无肝硬化。最后，我们将该病例诊断为无门静脉高压的肝外门体静脉分流。
