Bancu S, Moldovan O, Jimboreanu O, Zamfir D, Borz C
Clinica Chirurgicală Nr. III, Tg. Mureş.
Chirurgia (Bucur). 1998 May-Jun;93(3):165-9.
A 34-year-old woman with no history of any liver diseases was admitted to the service for a Budd-Chiari syndrome and an extensive thrombosis of the inferior vena cava. The symptoms of the portal hypertension were present, with an enormous ascites, mild esophagogastric varices, associated with increased edema of the lower limbs, perineum and abdominal wall. The diagnosis was established by color Doppler ultrasonography, CT and cavography. An ilio-mesenterico-atrial shunt, between the right iliac vein, the superior mesenteric vein and the right atrium was successfully performed, transdiaphragmatically, by abdominally and right thoracic approach, using a 35 cm Dacron prosthesis. Postoperative evolution was very good. The color Doppler ultrasonography showed a good flow in the shunts. After 14 days ascites decreased over 70% and the inferior edema almost disappeared. 2 month later ascites decreased over 80%, the esophageal varices and edema disappeared completely. To our knowledge, this is the first case in the country, in which a patient underwent ilio-mesenterico-atrial shunt for Budd-Chiari syndrome and inferior vena cava extensive thrombosis.
一名无任何肝脏疾病史的34岁女性因布加综合征和下腔静脉广泛血栓形成入院。存在门静脉高压症状，有大量腹水、轻度食管胃静脉曲张，伴有下肢、会阴和腹壁水肿加重。通过彩色多普勒超声、CT和腔静脉造影确诊。采用35厘米的涤纶人工血管，经腹部和右胸途径经膈肌成功实施了右髂静脉、肠系膜上静脉与右心房之间的髂-肠系膜-心房分流术。术后恢复良好。彩色多普勒超声显示分流处血流良好。14天后腹水减少超过70%，下肢水肿几乎消失。2个月后腹水减少超过80%，食管静脉曲张和水肿完全消失。据我们所知，这是该国首例因布加综合征和下腔静脉广泛血栓形成而接受髂-肠系膜-心房分流术的患者。
