Interventional embolization with fibrin glue for a large inferior mesenteric-caval shunt.
Interventional embolization with fibrin glue for a large inferior mesenteric-caval shunt.
复制标题
纤维蛋白胶介入栓塞治疗大肠系膜下腔静脉分流。
作者：
M. Nagino;N. Hayakawa;S. Kitagawa;M. Katoh;S. Komatsu;Y. Nimura;S. Shionoya
我们报道了一名 25 岁男性，无肝硬化，伴有低蛋白血症和低色素性贫血，发生大肠系膜下腔静脉分流的罕见病例。在这个大分流中，肠系膜下静脉和髂内静脉之间直接连通。分流导致的血流动力学变化被认为是导致他目前的临床问题和未来门体性脑病的原因。通过髂内静脉进行经皮经导管纤维蛋白胶分流栓塞，这改善了低蛋白血症并降低了血清氨水平，且没有任何并发症。对于门体分流术，应尝试介入放射学方法而不是手术结扎，纤维蛋白胶以及线圈或可拆卸球囊作为栓塞材料也很有价值。
We report an unusual case of a large inferior mesenteric-caval shunt in a 25-year-old man without cirrhosis with hypoproteinemia and hypochromic anemia. In this large shunt the direct communication was between the inferior mesenteric vein and the internal iliac vein. Hemodynamic change as a result of the shunt was thought to cause his present clinical problems and future portosystemic encephalopathy. Percutaneous transcatheter embolization of the shunt with fibrin glue was performed through the internal iliac vein, and this offered amelioration of hypoproteinemia and reduction of serum ammonia levels without any complications. An interventional radiologic approach instead of surgical ligation should be attempted for portosystemic shunts, and fibrin glue, as well as coils or a detachable balloon, is also valuable as an embolizing material.