Gil-Egea M J, Alameda F, Girvent M, Riera R, Sitges-Serra A
Departamento de Cirugía y Anatomía Patológica, Hospital Universitari del Mar, Barcelona.
Gastroenterol Hepatol. 1998 May;21(5):227-9.
Portal cavernomatosis consists in the substitution of the portal vein by many fine, twisting venules leading to the liver. This phenomenon is produced as a consequence of anterior thrombosis of the portal vein and is associated with chronic pancreatitis, cancer of the pancreas, intraabdominal sepsis and cholelithiasis. The symptomatology may be nul or present as obstructive jaundice or portal hypertension. Diagnosis is made by Doppler echography. The treatment is portal shunt when symptomatology is produced. In patients with cholelithiasis requiring surgery, the shunt is advised prior to biliary surgery since perioperative hemorrhage, if present, may be incoercible as in the case herein described. We present a 84-year-old woman with portal cavernomatosis the etiology of which was a hydatidic cyst located in the hepatic bifurcation and treated with mebendazol 10 years previously. This etiology has not been previously reported.
门静脉海绵样变性表现为门静脉被许多细小、扭曲的通向肝脏的小静脉所替代。这种现象是门静脉前部血栓形成的结果,与慢性胰腺炎、胰腺癌、腹腔内脓毒症和胆石症有关。症状可能不存在,或表现为梗阻性黄疸或门静脉高压。通过多普勒超声检查进行诊断。当出现症状时,治疗方法是进行门体分流术。对于需要手术的胆石症患者,建议在胆道手术前进行分流术,因为如果存在围手术期出血,可能像本文所述病例一样难以控制。我们报告一名84岁患有门静脉海绵样变性的女性,其病因是10年前位于肝门分叉处的包虫囊肿,曾用甲苯达唑治疗。这种病因以前尚未见报道。