Eriguchi N, Aoyagi S, Hara M, Miyazaki T, Tanaka M, Toyonaga A
Department of Surgery, Kurume University School of Medicine, Japan.
Kurume Med J. 1998;45(2):227-30. doi: 10.2739/kurumemedj.45.227.
This report describes a 49-year-old woman with recurrent massive gastrointenstinal bleeding from jejunal varices without portal hypertension. Preoperative diagnosis was obtained by abdominal computed tomography, superior mesenteric arterial angiography and percutaneous transhepatic portography. Percutaneous transhepatic portographic findings revealed no step-up of oxygen concentration and normal pressure in the portal vein, only dilation of superior mesenteric vein. Jejunal resection and anastomosis resulted in complete resolution of the bleeding, and the patient has experienced no recurrent bleeding over a 4 year follow-up period. A review of the literature shows that this syndrome is nearly always characterized by portal hypertension, generally due to liver cirrhosis. Accurate preoperative diagnosis is often difficult. We report a very rare case of jejunal varices without portal hypertension.
本报告描述了一名49岁女性，患有空肠静脉曲张反复大量胃肠道出血，且无门静脉高压。术前诊断通过腹部计算机断层扫描、肠系膜上动脉血管造影和经皮肝门静脉造影获得。经皮肝门静脉造影结果显示门静脉氧浓度无升高且压力正常，仅肠系膜上静脉扩张。空肠切除吻合术使出血完全缓解，患者在4年随访期内未再出血。文献回顾显示，该综合征几乎总是以门静脉高压为特征，通常由肝硬化引起。准确的术前诊断往往很困难。我们报告了一例非常罕见的无门静脉高压的空肠静脉曲张病例。
