Successful management of portal hypertension following artificial arterioportal shunting: report of a case.
A 63-year-old woman diagnosed as having hepatic hilar cancer underwent an extended left lobectomy of the liver with excision of the right hepatic artery which was involved by the tumor. Because the hepatic artery could not be reconstructed by direct anastomosis, an artificial arterioportal (A-P) shunt was constructed between the common hepatic artery and the portal vein. However, 4 weeks after the operation, portal hypertension with severe esophageal varices developed. Under the diagnosis of portal hypertension caused by excessive blood flow from the A-P shunt, coil embolization of the common hepatic artery was performed using an angiographic technique, following which the esophageal varices completely disappeared. This case demonstrates that portal hypertension after A-P shunting can be effectively treated with coil embolization.
Ko
S
S
First Department of Surgery, Nara Medical University, Japan.
Nakajima
Y
Y
Kanehiro
H
H
Aomatsu
Y
Y
Yoshimura
A
A
Taki
J
J
Ueno
M
M
Kin
T
T
Nakano
H
H
D000792:Angiography; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D003097:Collateral Circulation / Q000502:physiology; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000628:therapy*; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery; D008099:Liver / Q000098:blood supply; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012086:Reoperation