[A radical operation of Chiari's disease using the internal shunt tube of the inferior vena cava].
A case with the Budd-Chiari syndrome due to the right hepatic occlusion who was successfully operated by using the internal shunt tube of the inferior vena cava was reported. The patients was 33 year old male. Midsternal incision and right subcostal oblique incision were made and the internal shunt tube was inserted through the right auricle to the inferior vena cava. The hepatic vein was approached through the longitudinal suprahepatic caval venotomy. Then membranous obstruction in the right hepatic vein ostia was resected. Mesenteric venous pressure dropped immediately from 360mm H2O to 160mm H2O by direct manometry. All the blood bled from the right hepatic vein was transfused through the internal shunt tube to the right atrium. The patient tolerated the procedure and his postoperative course was free from the complication. The resected membrane was congenital anomaly and an operative liver biopsy was demonstrated the evidence of congestive liver with fibrosis.
Suzuki
I
I
Department of Surgery and Pathology, National Chiba Hospital, Japan.
Nishizawa
T
T
Kobayashi
J
J
Shiramatsu
K
K
Terashima
M
M
Takazawa
H
H
D000328:Adult; D006502:Budd-Chiari Syndrome / Q000151:congenital / Q000473:pathology / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods; D006503:Hepatic Veins / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology; D008297:Male; D008722:Methods; D013152:Splanchnic Circulation; D014682:Vena Cava, Inferior / Q000601:surgery*; D014690:Venous Pressure