Meyer R G, Orth T, Kreitner K F, Schirmacher P, Meyer zum Büschenfelde K H, Gerken G
I. Medizinische Klinik der Johannes-Gutenberg-Universität Mainz.
Z Gastroenterol. 1998 Nov;36(11):971-5.
Portopulmonary venous anastomosis are a very rare complication of chronic liver diseases. We report on a patient with a cryptogenic liver cirrhosis and thrombosis of the portal vein who underwent antibiotic treatment because of recurrent pneumonias several times. Although treated successfully a pulmonal infiltrate persisted in further radiologic controls. By means of a velocity-encoded MRI a portopulmonary shunt of 30% of the cardiac output was assured. An operative correction with a distal splenorenal shunt was performed successfully. Former reports of portopulmonary anastomoses complicating chronic liver disease never were hemodynamically relevant. In the presented case, a portopulmonary anastomosis lead to recurrent pneumonias and a restrictive ventilatory disorder.
肝肺静脉吻合术是慢性肝病一种非常罕见的并发症。我们报告了一名患有隐源性肝硬化和门静脉血栓形成的患者，该患者因多次反复发生肺炎而接受了抗生素治疗。尽管治疗成功，但在后续的影像学检查中肺部浸润持续存在。通过速度编码磁共振成像确定存在心输出量30%的肺内分流。成功实施了远端脾肾分流术进行手术矫正。既往关于慢性肝病合并肝肺静脉吻合术的报道从未涉及血流动力学方面的问题。在本病例中，肝肺静脉吻合术导致反复肺炎和限制性通气障碍。
